1. Laparoscopic Placement of the BardPort Intraperitoneal Catheter and Reservoir Dr. Arlan F. Fuller, Jr. Gillette Center for Women's Oncology Massachusetts General Hospital

2. Choice of Catheter and Reservoir is the IV Device

3. Titanium Port with 9.6F attached catheter

4. Pre-placement Procedure Perform laparoscopy in the usual manner with umbilical placement of laparoscope trocar and survey of the abdominal cavity for adhesions Place a 5 mm operative trocar in a position contralateral to the side of proposed catheter placement Identify the prospective site in the lower quadrant for entry of the catheter into the peritoneal cavity

5. Mark the site for reservoir placement above the right costal margin

6. Incise the skin and develop a pocket for the reservoir

8. Check that the reservoir fits snugly into the pocket

9. Place the tunneler on the end of the catheter and start the passage deep to Scarpa’s fascia

10. Place a 5 mm transverse incision at the target site

11. Bluntly with a hemostat extend the incision beneath Scarpa’s fascia to contact the tunneler

12. Pass the tunneler out through the target incision

14. Pass the catheter through the tunnel and the target incision and cut catheter to remove tunneler

15. Suture the reservoir in place to fascia and confirm catheter function

16. Place introducer needle through target incision adjacent to catheter

17. Visualize needle tip at the target site in the peritoneal cavity

18. Pass the guidewire with “J” tip through the introducer needle

20. Visualize “J” tip of the wire at the target site in the peritoneal cavity

21. Withdraw the introducer needle leaving the guidewire in place

22. Insert the introducer with the 10F dilator over the guidewire into the peritoneal cavity

23. Visualize the dilator AND the peel-away introducer in the peritoneal cavity Dilator Introducer

24. Withdraw both the wire and the dilator from the introducer

25. Pass the catheter through the introducer and assist laparoscopically in advancing the catheter into the peritoneal cavity

26. Peel away the introducer while holding the catheter in the peritoneal cavity

27. Advance all the remaining catheter into the peritoneal cavity

28. Adjust position of catheter tip and confirm function by injection Last, subcuticular closure of all incisions