A “how-to” demonstration highlighting the single-incision insertion technique of chest port placement

When compared with other diseases, few authors have reported on single-incision laparoscopic surgery (SILS) for liver cysts. We herein describe our experience with SILS for a huge liver cyst with the application of an umbilical Z-shaped incision using a gel port and a high-density monopolar saline-cooled radiofrequency device with a successful outcome. An 80-old-year woman was diagnosed with a huge liver cyst with abdominal pain. She underwent percutaneous drainage of the liver cyst and injection of both absolute ethanol and an antimicrobial agent into the liver cyst at the previous hospital. Because of re-expansion of the liver cyst and symptom recurrence, we performed SILS for the liver cyst. An umbilical Z-shaped incision was made for gel port placement. After aspiration of the cystic fluid and dissection of the thin cystic wall by laparoscopic coagulating shears, the thick cystic wall was divided using an endoscopic linear stapler to avoid bleeding and bile leakage. After wide fenestration, a high-density monopolar saline-cooled radiofrequency device was applied for the ablation of the remnant membrane of the cystic wall. All maneuvers could be performed only through the gel port. The patient was discharged 4 days after surgery and was satisfied with the cosmetic results. This case shows that the application of an umbilical Z-shaped incision using a gel port and a high-density monopolar saline-cooled radiofrequency device is useful for the accomplishment of SILS for a huge liver cyst.

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Wound Healing Failure Following Venous Access Chest Port Placement Associated with Ramucirumab Therapy

CardioVascular and Interventional Radiology ◽

10.1007/s00270-017-1752-8 ◽

2017 ◽

Vol 40 (11) ◽

pp. 1804-1806 ◽

Cited By ~ 2

Author(s):

Chenyang Zhan ◽

Amy R. Deipolyi ◽

Joseph P. Erinjeri

Keyword(s):

Wound Healing ◽

Venous Access ◽

Port Placement ◽

Chest Port

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Advanced stage breast cancer is associated with catheter-tip thrombus formation following implantable central venous port placement

Phlebology The Journal of Venous Disease ◽

10.1177/0268355518774442 ◽

2018 ◽

Vol 34 (2) ◽

pp. 107-114 ◽

Cited By ~ 2

Author(s):

Mina S Makary ◽

Alexander Lionberg ◽

Mamdouh Khayat ◽

Maryam B Lustberg ◽

Jamal AlTaani ◽

...

Keyword(s):

Breast Cancer ◽

Thrombus Formation ◽

Large Population ◽

Advanced Stage ◽

Central Venous ◽

Port Placement ◽

Chest Port ◽

Significant Difference ◽

Catheter Tip ◽

Tip Position

Purpose Catheter-tip associated thrombosis is not uncommon in patients with implantable central venous ports; however, the prevalence and clinical impact of this complication on patient management is unclear. This study aims to identify risk factors for thrombus formation in a large population receiving serial echocardiograms (echo) following port placement. Methods A total of 396 female breast cancer patients underwent internal jugular vein chest port placement between 2007 and 2013 and received echo studies every third month. Catheter tip position was measured from chest radiography and catheter associated thrombus was identified by echo. Results Sixteen out of 396 patients (4%) had catheter-tip thrombus. No patients were symptomatic or prophylactically anticoagulated. Patients with thrombus were significantly younger than those without (46.4 years versus 53.4 years, respectively, p = 0.02) and had higher stage breast cancer with 75% versus 44.7% having stage III or IV cancer ( p = 0.017). Thrombus was identified after a median of 91 days. No significant difference was identified in anatomic ( p = 0.1) or measured ( p = 0.15) tip position, port laterality ( p = 0.86), or number of port lumens ( p = 0.65). Conclusions In this large cohort, younger patients and those with more advanced stage breast cancer were more associated with catheter-tip-related thrombus after port placement.

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