[Introducing an implantable central venous catheter via the right pudendal vein]

Implantable central venous catheters are routinely introduced in the subclavian or jugular veins. In some cases such as thrombosis or infection, this localization must be avoided. In these circumstances, the inferior vena cava is used. The catheter can be inserted into the inferior vena cava via the right genital vein. Surgery is performed under general or loco-regional anesthesia. The right genital vein is approached using a MacBurney incision. The retroperitoneum is entered and the right genital vein is cannulated. The catheter tip is placed at the limit between the inferior vena cava and the right atrium. The port is placed in a subcutaneous pocket in the lower part of the thorax. In cases where the right genital vein is too narrow to allow catheterization, it is easy to proceed through the same incision and puncture the inferior vena cava.