The procedure
The patient is taken to the operating room when the necessary formal consents have been given and he has intravenous access (a venflon), through which sleeping agents will be administered. During your stay at the ATTIS Center Hospital, the most comfortable thing to do is to wear two-piece pajamas and slippers. Just before entering the operating room, the upper part is replaced with a fleece shirt, which we will not regret if it gets dirty with disinfectant fluids or blood, or tears after surgery when removing the sterile draping drapes of the operating field.
Once the patient is placed on the operating table with the soft heating mattress, we have to "wire" him - we use various sensors to monitor the patient's condition - a finger pulse oximeter to show blood oxygenation, an arm compression cuff to measure blood pressure, a drain to measure carbon dioxide in exhaled air, again a face mask through which a mixture of oxygen and air is administered, and cables from the ECG. For the safety of the patient, we will do everything ? The operating field is protected with sterile drapes, which cover the patient from head to foot, and some pieces of drapes are taped to the face and neck. Then, we again check the patency of the venflon and - if it is not objectionable - we start the infusion of a sleeping agent. Once the patient is asleep, local anesthesia is performed, that is, injecting the insertion and incision sites with a local anesthetic (lignocaine). The injection is not pleasant, and at first it simply causes pain, so it is performed after sleep. Sleep is not anesthesia, but it allows the local anesthesia to be performed in a way that is comfortable for the patient. On the other hand, properly performed local anesthesia significantly reduces the doses of sleeping agents needed to keep the patient comfortable.
The procedure begins after the patient has been put to sleep and local anesthesia has been achieved.
For IV anesthesia to be used safely, the patient must be fasting. This means abstaining from consuming liquids and solid foods 4 hours before the procedure begins. Since it usually takes at least an hour from admission to the hospital to the start of the procedure, so we can assume that a person who has not eaten or drunk for three hours before showing up at the hospital is fasting 4 hours at the time of the procedure and can be anesthetized in this way. We have not met anyone who is dissatisfied with this procedure. On the contrary. This doesn't mean that the procedure can't be done under local anesthesia only - many implantations are done this way, but - as with gastroscopy, it can be done, however, most people prefer to "take a nap".
On the skin of the neck above the clavicle, one cut of a few millimeters is made to insert the catheter into the vein - about 4-5 mm, under the clavicle a longer one is made to place the port chamber - about 1.5 - 2 cm. Both are secured with absorbable sutures hidden under the skin, so there are no sutures to remove after the procedure.
Duration of stay in the operating room is not likely to be more than 40 minutes.