Y-TEC Abbreviated Instructions

The Y-TEC System is quick, relatively easy to perform, and produces consistent results; in other words, it is effective.

The main steps of the Y-TEC System are:

1. Visualization of the abdomen
2. Puncture of the abdominal wall
3. Dilation of the rectus sheath

Use of the Y-TEC System for catheter implantation leads to quick implantation procedures, consistent results, and excellent short- and long-term outcomes.

Coupled with this technique is an optional step: Embedding (burying) the catheter at the time of implantation for retrieval and use at a later time. The Embedding Tool allows the implanting physician to schedule the catheter implantation procedure well in advance of the onset of the need for PD, eliminating the often rushed, frantic implantation at the last minute, hoping that a catheter is in stock, a doctor is on-hand, and that an operating theater is available.

These steps make all the difference in outcomes: it is critical that the implanting physician see what is happening in real time, and ‘puncture and dilate’ instead of ‘cut and spread’ greatly reduces the risk of infections and other complications. It also significantly reduces patient recovery time, even allowing supportive dialysis to begin immediately, if necessary.

Abbreviated Instructions

See Medigroup’s Y-TEC Instructions for Use for more detailed instructions, and qualified, recognized, standard medical texts and/or related literature for specific details, results, risks, and prescription information.

	1. The Quill Guide Assembly is introduced into the peritoneum at a 40° angle. After insertion of Quill Catheter Guide Assembly, the Y-TEC scope is advanced into the furthest visible space within the abdomen avoiding adhesions and omentum.
	2. The Quill Guide Assembly creates the minimum size hole (2.5mm) for puncturing the rectus muscle. Its length-wise slit enables it to expand the rectus muscle when dilated to create a tight seal and minimize leaks.
	3. The small and large diameter dilators dilate the Quill Guide and the rectus muscle.
	4. The catheter is implanted with ease, as the rectus muscle still has the tension to secure the cuff without a suture. The catheter is implanted by slowly advancing the catheter (with the stylette in it) through the Quill Catheter Guide.
	5. The Y-TEC Cuff Implantor Tool pushes the rectus cuff securely and safely into the rectus muscle, while minimizing the probability of the cuff going too deep through the rectus muscle.
	6. After the Cuff Implantor Tool, Quill Guide, and stylette are removed the catheter is tested. If the catheter functions well, it is tunneled with the Y-TEC Tunnelor Tool. The Tunnelor Tool dilates the subcutaneous tissue and skin exit-site to the size of the catheter, minimizing tunnel and exit-site infections and leakage.

The laparoscopic Y-TEC system is designed to be used with the hospital’s existing laparoscopic instruments and optional video equipment. After standard laparoscopic insertion into and inspection of the abdomen, the surgeon uses the contents of the Y-TEC VP-210 pac to implant the catheter. It contains the patented Quill Guide Assembly*, the patented Cuff Implantor†, small and large Dilators, and Tunnelor Tool.

This pac and procedure can be used to implant almost all PD catheters including the Flex-Neck, Swan-Neck™, and conventional catheters. (The Toronto Western and Missouri Swan-Neck catheters cannot be implanted with this technique.)