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Technique for cuffed central line insertion in paediatric cases.

When performing open Broviac line insertion in children, difficulty can be encountered cannulating the relatively small vein. We describe a technique that keeps the venotomy open, allowing for easier insertion. Using a 6/0 Prolene® suture (Ethicon, Somerville, NJ, US) tagged with a micro mosquito forceps, a bite is taken at the midpoint of the venotomy, the suture passed around a Ragnell retractor and a second bite taken of the opposite vein wall. Loop tension is adjusted to achieve triangulation, keeping the venotomy open, allowing for easy cannulation. Suture tying results in elegant venotomy closure and a bloodless surgical field.