Biohole needle and plug set for buttonhole technique

[monrein]

Does anyone here have any experience with the biohole plug and needle set for establishing buttonholes?  I found a reference to it someplace but don't know if this is only available in Europe. 

[BigSky]

Read something on it a year or two ago.  Little plastic type collar used to help guide needles to form buttonhole.  At the time it seems like it was available only in Europe.  Cannot even remember who the manufacture was of the product.   Track the manufacture down and one might be able to see if they offer the product in the US through their US supplier now.

[flip]

They are available from Baxter and several other companies.

[monrein]

I have an appointment to tour the self care dialysis unit near me and I'm going to ask them.  The ones I heard about were made by Nipro.  I like the idea that it would only take two weeks to establish buttonholes.

[flip]

Baxter has them listed on their website. The list price is $86 and they come in 15 or 16 gauge.

[petey]

I went to the Baxter website to see what these things looked like, but I could only find the prices.  What exactly do these look like and how do they work?  We established Marvin's buttonholes in one week using a regular sharp 15 gauge needle.  If there's an easier way, I want to know about it because we've heard that buttonholes will "wear out."  Anybody have more details on this?

[MIbarra]

I found a pic of them and explanation of use. Can I post the website or not?

Basically it looks like a little plastic peg which you insert AFTER you are done with treatment and it stays in there kinda like a "place holder." You take it out to put the needles in when you need to have dialysis and replace it when you're done until the buttonhole is established.

[petey]

please post the website -- I want to see

[MIbarra]

I found a LONG word processing document that seems to be from a medical dialysis conference. I've copied and pasted the reference to the biohole peg.

"Buttonhole cannulation technique is a method of cannulation of native arterio-venous fistulae traditionally practiced by self cannulators. At St. Michael’s Hospital this method has been modified to allow its use in problematic fistulae by multiple cannulators. The need for a few cannulators to establish the tunnel tracks and the variable dialysis schedules creates logistic challenges for the creation of buttonholes in a busy unit. We evaluated the time saving method to create tunnel tracks for buttonhole cannulation described by Toma et al. In this method, a polycarbonated peg, the BioHole device, is inserted along the path of the recently removed dialysis needle. Using this technique, the development of the tunnel track is facilitated by the indwelling peg between treatments."

This is the URL for the picture I found.

http://www.buttonhole.nl/Biohole%20Small.pdf

[kidney4traci]

It only took a week to establish my buttonholes, using a sharp for only 5-6 times before being able to use the buttonhole needles.  I don't know why they are saying it takes 2 weeks. ??

[petey]

interesting...very interesting

[monrein]

Thanks for all your replies and comments and also that link.  I saw my vascular surgeon today and the nurse.  They are pleased with my fistula as it's only been 10 days and its developing nicely already.  I asked the nurse about the biohole and plug business and she was very helpful.  I'm going to visit a self-care dialysis unit next week and when the time comes they've said they'll try to get someone to teach me the buttonhole.  They don't do it at the Toronto General, nor do they usually do it at the self-care facility but the nurse said the team will get me linked to someone that knows about it.  My guess is that the literature says 2 weeks so people won't be disappointed if their buttonholes take longer than 5-6 times to establish but I'm just guessing.
They've told me that they won't train me for home hemo unless I'm going to be on for a year minimum so my plan is to do self-care and try to talk them into making an exception if I do really well.  I'm also very aware that although I have potential donors going to be tested, there are no guarantees so I'm planning for the longer term.  I always hope for the best but kind of expect the worst.  I don't even know at this point if we have Nxstage in Canada but gotta take it one thing at a time.  Dialysis was a wild and trippy thing back almost 30 years ago when I was on for 5 long years.  I'm intrigued by the biohole plugs.  Actually the name cracks me up for some reason.  Proof positive that I've got to get out more.  Can't you just see shouting at some tech "Oh for heavens sake go shove a plug in your biohole"  Hmmm on the other hand maybe that's what they'll be shouting at me.

[MIbarra]

"Oh for heavens sake go shove a plug in your biohole"  Hmmm on the other hand maybe that's what they'll be shouting at me.

HA HA HA HA HA HA!!! I needed that... It's been a LONG week.

=)