H.23 Hands Free Paracentesis Catheter

Paracentesis is a procedure done to drain fluid from the abdominal (peritoneal) cavity. Analysis of this fluid is essential to determine the cause for the buildup of excess fluid, whether it is due to portal hypertension (as seen in liver disease), cancer, infection, or pancreatitis. Removal of the fluid also has therapeutic benefit by reliving pressure-driven abdominal discomfort and respiratory distress. 

The procedure is done by introducing a catheter through the abdominal wall and into the peritoneal cavity. Once it is placed, fluid is drawn through the catheter for analysis. After this, if a large volume of fluid needs to be removed the catheter is connected to negative pressure (via wall suction or evacuated containers). As the containers fill, the process is paused and they are exchanged with new containers until the desired amount of fluid is removed. The flaw with this design is that the catheter is not secured within the patient’s abdominal cavity. As the proceduralist pauses to exchange containers, there is a risk that the catheter could be displaced and slide out. This risk is even greater for patients who are agitated or have an abundance of subcutaneous tissue. If the catheter becomes displaced, the proceduralist will have to decide whether to terminate the procedure prematurely or open a new paracentesis kit and replace the catheter.

The goal of this project is to design a catheter that addresses this flawed design in the paracentesis procedure, specifically to come up with a mechanism that temporarily secures the catheter in place for the duration of the procedure. This would allow for the proceduralist to free his/her hands from holding the catheter in place to perform other necessary components of the procedure

References:
Thomsen TW, Shaffer RW, White B, Setnik GS. Videos in clinical medicine. Paracentesis. N Engl J Med. 2006 Nov 9;355(19):e21. doi: 10.1056/NEJMvcm062234. Erratum in: N Engl J Med. 2007 Feb 15;356(7):760. PMID: 17093242.

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