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PREOPERATIVE DIAGNOSIS: Rhabdomyosarcoma of the left orbit.

POSTOPERATIVE DIAGNOSIS: Rhabdomyosarcoma of the left orbit.

PROCEDURE: Left subclavian vein MediPort placement (7.5-French single-lumen).

INDICATIONS FOR PROCEDURE: This patient is a 16-year-old girl, with newly diagnosed rhabdomyosarcoma of the left orbit. The patient is being taken to the operating room for MediPort placement. She needs chemotherapy.

DESCRIPTION OF PROCEDURE: The patient was taken to the operating room, placed supine, put under general endotracheal anesthesia. The patient's neck, chest, and shoulders were prepped and draped in usual sterile fashion. An incision was made on the left shoulder area. The left subclavian vein was cannulated. The wire was passed, which was in good position under fluoro, using Seldinger Technique. Near wire incision site made a pocket above the fascia and sutured in a size 7.5-French single-lumen MediPort into the pocket in 4 places using 3-0 Nurolon. I then sized the catheter under fluoro and placed introducer and dilator over the wire, removed the wire and dilator, placed the catheter through the introducer and removed the introducer. The line tip was in good position under fluoro. It withdrew and flushed well. I then closed the incision using 4-0 Vicryl, 5-0 Monocryl for the skin, and dressed with Steri-Strips. Accessed the ports with a 1-inch 20-gauge Huber needle, and it withdrew and flushed well with final heparin flush. We secured this with Tegaderm. The patient is then to undergo bilateral bone marrow biopsy and lumbar puncture by Oncology.

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