Zhang Miaomiao, Lyu Xin, Wang Juanjuan, Shi Aihua, Zheng Yunyun, Lyu Yi, Yan Xiaopeng
Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Front Surg. 2023 Sep 25;10:1241780. doi: 10.3389/fsurg.2023.1241780. eCollection 2023.
A totally implantable venous access port (TIVAP) is a commonly used intravenous infusion device for patients receiving chemotherapy or long-term infusion therapy. To improve the success rate of one-time insertion of the Huber needle, we developed a novel Y-Z magnetic TIVAP (Y-Z MTIVAP), which we produced using three-dimensional printing technology.
The Y-Z MTIVAP includes a magnetic port body and a magnetic positioning device. For testing, we established four venous port implantation models using the two types of TIVAPs and two implantation depth ranges (≤5 mm and >5 mm). Twenty nurses performed Huber needle puncture with the four models, and we recorded the number of attempts required for successful needle insertion, the operation time, and the operator's satisfaction.
The success rate for one-time needle insertion with the Y-Z MTIVAP was significantly higher than that with the traditional TIVAP at either depth range (100% vs. 75% at ≤5 mm, = 0.047; 95% vs. 35% at >5 mm, < 0.001). With increasing implantation depth, the success rate for one-time insertion was significantly reduced with the traditional TIVAP (75% at ≤5 mm vs. 35% vs. >5 mm, = 0.025), but the success rate with the Y-Z MTIVAP was not significantly affected (100% vs. 95%, = 1.000). The operation time with the Y-Z MTIVAP was significantly shorter than that with the traditional TIVAP at either depth range (both < 0.001), and 90% of operators reported that the Y-Z MTIVAP was superior to the traditional TIVAP.
The theoretical design of Y-Z MTIVAP is feasible, and the preliminary simulation experiment shows that it can significantly improve puncture success rate and shortened operation time.
全植入式静脉输液港（TIVAP）是化疗或长期输液治疗患者常用的静脉输液装置。为提高休伯针一次性穿刺成功率，我们开发了一种新型Y-Z磁性TIVAP（Y-Z MTIVAP），采用三维打印技术制作。
Y-Z MTIVAP包括磁性端口体和磁性定位装置。为进行测试，我们使用两种类型的TIVAP和两个植入深度范围（≤5 mm和>5 mm）建立了四个静脉输液港植入模型。20名护士对这四个模型进行休伯针穿刺，我们记录成功穿刺所需的尝试次数、操作时间以及操作者的满意度。
在任一深度范围内，Y-Z MTIVAP的一次性穿刺成功率均显著高于传统TIVAP（≤5 mm时为100%对75%，P = 0.047；>5 mm时为95%对35%，P < 0.001）。随着植入深度增加，传统TIVAP的一次性穿刺成功率显著降低（≤5 mm时为75%对>5 mm时的35%，P = 0.025），但Y-Z MTIVAP的成功率未受显著影响（100%对95%，P = 1.000）。在任一深度范围内，Y-Z MTIVAP的操作时间均显著短于传统TIVAP（均P < 0.001），90%的操作者报告Y-Z MTIVAP优于传统TIVAP。
Y-Z MTIVAP的理论设计可行，初步模拟实验表明其能显著提高穿刺成功率并缩短操作时间。
