Where can one get surface markers and whats the advantage?
One can make them using a old angiographic catheter. Cut into strips and make it into a grid. These offer more precision and aid accurate efficient procedures.
Whats CT fluroscopy?
Most modern CT machines come with a CT fluroscopy option. One use the foot pedal inside the scanner, to quickly identify the needle tip position, allowing precise, more independent and efficient procedures.
Patient reluctant for further surgery. The collection was poorly delineated on ultrasound. CT guided drainage performed.
Step-by-step images of CT guided Seldinger drainage, using CT fluroscopy.
1. Surface markers to aid drainage in place. See how much more difficult the collection is visualize without contrast in terms of performing the procedure.
2. After local anaesthetic infiltration, the 2 part introducer needle is inserted and the position rechecked, before entering the retroperitoneum.
3. Introducer needle enters the collection, with the use of CT fluroscopy. Pus is aspirated to confirm exact location.
4. Stiff guidewire placed into collection
5. Distance to edge of collection measured to be aware of distance to advance the metal trocar, before leaving the drain in situ.
6. 8F locking drain within the collection