What to Expect During the Implant Procedure for Targeted Drug Delivery

If you and your doctor decide to use a drug pump as part of your pain management plan, the system will be implanted during a surgical procedure. This procedure is most often performed in a hospital or outpatient surgery center.

The SynchroMed® II pump is available in two sizes—20 ml and 40 ml—to meet your size preference and refill schedule. Your doctor will decide which size is right for you.

SynchroMed II Pump Sizes

See the two sizes of the SynchroMed® II pump.

Before the procedure, you and your doctor will decide where in your abdomen to position the drug pump for your comfort.

During your procedure:

  • You will be placed on an operating room table, probably on your side.
  • Typically, the implant is performed under general anesthesia.
  • Your doctor makes an incision (about 15 cm long) in your abdomen. This is where the pump is placed.
  • Your doctor will form a pocket under the skin that is large enough to hold the pump. This pocket is in the abdomen.
  • A second incision (about 5 to 8 cm long) is made on your back. This incision is used to place one end of the catheter into the intrathecal space.
  • The other end of the catheter is tunneled under the skin and connected to the pump, resulting in a fully implanted system.
  • Once the drug pump and catheter are in place, the doctor closes the incisions and completes the surgery.
  • The procedure takes approximately 1 to 3 hours.
  • The length of your hospital stay will vary depending on your doctor’s preference and hospital procedures.

Risks of Targeted Drug Delivery

The implanted pain pump and catheter are surgically placed under the skin. Surgical complications are possible and include infection, spinal fluid leak, and headache. You should not undergo the implant procedure if you have an active infection at the time scheduled for implant.

Once the infusion system is implanted, device complications may occur that may require surgery to resolve. Drug overdose or underdose can result because of these complications and have serious and even life-threatening adverse effects. Possible complications include the catheter or pump moving within the body or wearing through the skin. The catheter could leak, tear, kink, or become disconnected. The pump could stop because the battery has run out or because of failure of another part of the infusion system. Additionally, inflammatory mass has been reported at the tip of the catheter which may lead to complications, including paralysis.

For additional safety information, please refer to Important Safety Information. Always discuss the potential risks and benefits of the therapy with your doctor.

One Patient’s Decision to Go On Long-term Targeted Drug Delivery

Rob

Targeted Drug Delivery Since 2005
"You'll know whether it's worth taking the next step or not."

What to Expect During the First Weeks of Recovery

The recovery time after getting the therapy is usually 6-8 weeks. You may experience some initial discomfort and limits on movements. Be sure to listen to your body and follow your doctor's instructions.

After a few weeks, it's a good idea to try some activities you enjoy, such as going for a walk, riding your bike, going to a movie, or watching a ball game. Talk with your doctor about activities you'd like to try or tasks you'd like to accomplish.

What to Expect From Long-term Targeted Drug Delivery

Dr. David Provenzano

Pain Management Specialist, USA
"One of the expectations that you clearly have to have with most chronic pain treatments is that this is not a complete cure. It’s a way for us to reduce pain and help you function better."

Making Adjustments to Your Pain Therapy

myPTM Personal Therapy Manager for Targeted Drug Delivery
myPTM Personal Therapy Manager for Targeted Drug Delivery

Your doctor will use a computer-like programmer in his or her office to program the pump. Because pain symptoms can change with specific activities or at certain times of the day, the dose and/or program can be individualized so that you receive the best pain relief possible. For example, to prevent pain from interfering with sleep, the pump can be programmed to deliver more pain medicine at night. Be sure to tell your doctor about the way you feel, so changes can be made to optimize your pain management.

If your doctor prescribes it, you may receive a remote control device, shown here, to help control unpredictable pain. The handheld myPTM® Personal Therapy Manager works with your SynchroMed II drug pump and allows you to get an extra dose of pain medication when needed and within limits set by your physician. That way you may be able to do the things that are most important to you and enjoy more of what life has to offer.

What to Expect at Your Refill Appointment

During the refill appointment, your doctor will assess your symptoms, check that your drug delivery system is working properly, and confirm you are receiving appropriate therapy.

The SynchroMed II drug pump will be emptied with a needle inserted through your skin. The pump will then be refilled with medication. This is a relatively short and painless procedure. On average, a refill appointment lasts 35 to 45 minutes. How often you need to refill your pump depends on your individual dosing schedule and the size of your drug pump.

What to Expect During Daily Life With Targeted Drug Delivery

Talk with your doctor about the types of activities that may be easier with targeted drug delivery. Develop a plan for doing the things that matter most to you. Setting goals is important to get the most out of long-term targeted drug delivery.

Once you have a targeted drug delivery system, make sure you call your doctor straight away if you:

  • Experience additional or unusual pain
  • Notice changes in the effect your therapy is having on your pain
  • Think you need to increase the intensity of your therapy
  • Hear the pump alarm