Surgery: What to Expect – Implanting the SynchroMed^® II Pump

Medtronic pump surgery takes approximately 1 to 2 hours from start to finish, depending on individual surgical techniques and preferences. Your doctor will be able to answer any questions you may have about the specifics of your procedure.

Before the Procedure

Your surgery to receive the Medtronic SynchroMed^® Programmable Drug Infusion System may require a brief hospital stay, or it may be done on an outpatient basis. Before the procedure, you and your doctor will decide where the best position of the pump should be for it to be comfortable, usually this position is under the skin below the belt-line to one side of the lower abdomen.

During the Procedure

Typically, the surgery is performed under general anaesthesia, but you may discuss alternatives with your doctor. During surgery, the pump will be placed just under the skin of the lower abdomen.

The pump will be connected to a small, flexible thin silicone tube called a catheter. The catheter is tunneled beneath the skin around the flank of the child and into the intrathecal space containing the cerebrospinal fluid (CSF) which cushions, bathes and nourishes the spinal cord, into which it will deliver the medication.

After the Procedure

After surgery, there will be some discomfort and tenderness where the pump and catheter have been implanted. Your doctor may prescribe medication to relieve any pain caused by surgery and antibiotics to prevent infection. Tell your doctor if you notice any swelling, pain, or redness near your incisions.

Depending on your doctor’s preference, the pump may be filled during or after surgery. However, some doctors recommend a short waiting period to allow you to recover from surgery and get adjusted to the pump.

You’ll begin receiving treatment as soon as the pump is filled with anti-spastic medication and the medication travels through the catheter to the intrathecal space. You may feel effects from the medication soon after delivery, or it may take awhile for you to experience benefits. It may take several weeks to months to reach your optimal dose.

Potential Surgical Complications

ITB Therapy^SM can be helpful to people with severe spasticity.

Potential surgical complications may include:

• Infection
• Meningitis
• Spinal fluid leak
• Paralysis
• Headache
• Swelling
• Bleeding
• Bruising

Drug Side Effects

ITB Therapy drug side effects are usually temporary and may be managed by adjusting dosage.

The most common side effects include:

• Loose muscles
• Sleepiness
• Upset stomach and vomiting
• Headaches
• Dizziness

Ask your physician for information on the side effects you can expect from the medication used in the pump.

Symptoms of Medication Withdrawal

Please follow your doctor’s instructions closely because a sudden stop of your intrathecal therapy can result in serious illness caused by withdrawal from your anti-spastic medication, such as:

• High fever
• Changed mental status
• Muscle rigidity
• Multiple organ-system failure and death (in rare cases)

It’s important to keep your scheduled refill visits so you don’t run out of medication in your pump. You should know how to recognize the early symptoms of withdrawal, which include:

• Increase or return in spasticity
• Itching
• Low blood pressure
• Lightheadedness
• Tingling sensation

Potential Device Complications

Once the infusion system is implanted, possible device complications may include:

• Catheter or pump moving within the body or eroding through the skin
• Leakage, tearing, kinking, or disconnection of the catheter resulting in underdose or no medication infusion
• Pump failure leading to overdose or underdose of your anti-spastic medication

 

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