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this video demonstrates removal of a tunnel dialysis catheter in patients with end-stage renal disease demonstrated here is a right internal jugular tunnel dialysis catheter we are pointing towards the cuff of this tunnel dialysis catheter here we demonstrate that the cuff holds this tunnel dialysis catheter to the chest wall to adequately remove this tunnel dialysis catheter first lidocaine is injected around the track of the catheter this is done to anesthetize the area on the chest wall next the catheter is pulled via left hand as demonstrated in this video applying traction and at the same times medicine bomb scissors are used to dissect the cuff from the surrounding chest fault tissue as demonstrated here its important to first dissect free the cuff from the chest fault tissue while maintaining adequate tension via the other hand as demonstrated here once circumferential dissection is completed and the cuff is dissected free from the surrounding tissue we then proceed with divid