TIVAD implantation - general and visceral surgery

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  • Topography of the subclavian vein

    Demonstrating the anatomical relationship of the scalene muscle, subclavian/brachial artery and vein, and the relation of the clavicle regarding these two vessels.

  • Infiltrating the surgical site with local anesthetic

    Insert needle about 1 finger width inferior to the clavicle at roughly its middle and apply a total of 10 mL of local anesthetic, both as a wheal and in subclavian direction.

  • Puncturing the subclavian vein

    Puncture the vein with the needle initially at 70°-90° to the clavicle; after feeling no more resistance and with the needle definitely inferior to the clavicle, change the direction and advance the needle toward the (marked) suprasternal notch. Verify correct intraluminal placement by drawing venous blood into syringe.

  • Seldinger technique

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  • Inserting the port tubing

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  • Preparing the port pouch

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  • Subcutaneous tunneling

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  • Final functional verification

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date of update: 29.09.2018
date of publication: 09.07.2012

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