Neuromodulation in Practice: Procedural Insights from the Cadaver Lab-Intrathecal Drug Delivery System Implantation

Video Transcription

Video Summary

This video details the process of intrathecal pump pocket formation, typically placed in the abdomen on either side based on patient preference and anatomical considerations to prevent discomfort. The surgeon identifies the site preoperatively, ensuring the pump sits comfortably between the ribs and iliac bone, avoiding friction with clothing. An incision is made, and a pocket is carefully dissected to a depth suited to the patient's subcutaneous fat, aiming to keep the pump non-palpable. Catheters are tunneled and connected to the pump, ensuring cerebrospinal fluid (CSF) flow remains unobstructed. The pump is anchored securely with four non-absorbable sutures to prevent flipping, which could hinder refilling. The catheter is looped beneath the pump to avoid damage during refills. Closure involves layered suturing of deep tissues up to the skin, using absorbable sutures internally and non-absorbable or staples externally. Proper pump orientation is documented to facilitate safe future refills.

Keywords

intrathecal pump

pump pocket formation

catheter tunneling

surgical incision

pump anchoring