Blind percutaneous insertion of Hickman lines by a specialist team

Background: Long-term intravenous lines for the delivery of chemotherapy ca n be inserted by the percutaneous route or under direct vision by surgical exploration. Though the percutaneous route is widely used, many centres sti ll employ a surgical approach. This study evaluates the safety of the blind percutaneous approach. Method: Prospective records were kept of all Hickman lines inserted on the oncology unit of a large teaching hospital. Results: 127 consecutive lines were inserted in 115 adults by a single surg eon over a 30 month period using a blind percutaneous approach. There were 4 complications of insertion: 2 pneumothoraces (1.6%), 1 arrhythmia (0.8%) and bleeding from the subcutaneous tunnel (0.8%). Only 1 line had to be rem oved in the first 14 days because of hub fracture and leakage. Conclusions: Percutaneous insertion of Hickman lines using the blind techni que is associated with a low incidence of complications when performed by a n experienced operator.