Identification of the appropriate fixation site to avoid peritoneal catheter migration based on a mechanical analysis

Wang, Yujuan; Zou, Yao; Chen, Xinghua; Zhu, Jili; Xiang, Cuizhi; Jia, Houjun; Ding, Guohua; Wang, Huiming

doi:10.1080/0886022x.2017.1291433

Cited by 2 publications

(3 citation statements)

References 19 publications

(9 reference statements)

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“…Occasionally, large extent shift of the catheter tip under certain forces may result in catheter migration. Through the computational simulation and mechanical analysis, we had ascertained the necessity of additional catheter fixation and also identified the appropriate fixation site . Actually, a large body of evidence from others has emphasized the need for additional catheter fixation to avoid migration .…”

Section: Discussionmentioning

confidence: 99%

“…Recently, additional catheter fixation has been emphasized by us and others in preventing catheter migration (17)(18)(19)(20)(21)(22)(23). We had further analyzed the mechanical mechanism of why and where to fix the catheter (24). We also developed a novel maneuver of catheter fixation in the assistance of an apparatus termed "Wang's forceps," which has been implemented in the approach of open surgical catheter insertion or displaced catheter reposition (23,25).…”

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confidence: 99%

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Wang's Forceps‐Assisted Percutaneous Insertion and Fixation of Peritoneal Dialysis Catheter

Wang

Zhu

et al. 2018

Artificial Organs

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Percutaneous insertion of peritoneal dialysis catheters is theoretically most preferred by nephrologists because of the advantages of bedside performing, surgery independence, and minimal injury over other procedures of catheter placement such as open surgical dissection or laparoscopic operation. However, blindly placing catheters in the percutaneous procedure brings the risk of catheter malposition or bowel perforation; this largely retarded it's implementation. We had previously developed a novel technique termed "Wang's forceps-assisted catheter insertion and fixation," which had been successfully applied in the open surgical catheter insertion and displaced catheter reposition in our center. In this study, we further explored the possibility of applying the Wang's forceps in the procedure of percutaneous catheter insertion both in porcine model and patients with end stage renal disease (ESRD). A total of three miniature pigs successfully received percutaneous catheter insertion using Seldinger's technique with Wang's forceps assistance. The catheters were all placed in the right position and functioning well in dialysate drainage. This novel method of percutaneous catheter insertion was then performed on 20 ESRD patients. The procedure showed effective time-saving with the average operating time of 29.2 ± 3.53 min and was well tolerated by patients with minimal pain and injury. During a follow-up time of 6 months, no complications of catheter displacement, leakage, or blockade occurred. Our preliminary observation demonstrates that utilization of Wang's forceps in a percutaneous procedure conferred benefits of accurately placing and fixing catheters while preserving the merits of minimal invasion and simple performance.

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confidence: 99%

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confidence: 99%

Wang's Forceps‐Assisted Percutaneous Insertion and Fixation of Peritoneal Dialysis Catheter

Wang

Zhu

et al. 2018

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“…The study found that the site 9 cm from the interior catheter cuff had the least risk of migration rate and intraperitoneal complication. 3 In addition, in the present case, the free-moving greater omentum at the right side of abdomen was also suture-fixed to the right upper quadrant to help expose the small intestinal mesentery and prevent the potential wrapping of the tip of the PD catheter by the greater omentum. The greater omentalpexy technique was described in the literature.…”

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Laparoscopic-Assisted Abdominal Wall Pexy of Peritoneal Dialysis Catheter

Wei

Fanous

2020

The American Surgeon

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Background Peritoneal dialysis (PD) for rural patients with end-stage renal disease (ESRD) is convenient, efficient, and durable. However, patients with a history of previous abdominal surgeries or peritonitis are at an increased risk of PD malfunction. This case highlights the impact of securing the catheter to the abdominal wall laparoscopically to keep the PD catheter in an adhesion-free area to maintain patency and function in a patient with extensive intraperitoneal adhesions. Subject A 76-year-old white male was on PD which later was complicated with peritonitis and sepsis and subsequent catheter removal. A year later, the patient desired replacement of the PD catheter. Intraoperatively, diagnostic laparoscopy revealed significant intraperitoneal adhesions mainly located at the left side of the abdomen with the right side of the abdomen spared. The Tenckhoff PD catheter, which was straightened by a steel stylet, was inserted via a 5-mm trocar. The stylet was removed. The pig tail of the PD catheter was navigated away from the adhesion and directed to the right side of the abdomen for internal fixation. The catheter at 9 cm from the PD catheter cuff was attached to the right paramedian peritoneum. Results PD started 1 week after placement. The patient had excellent inflow and outflow for 14 months to date without complication or need for revision. Conclusion The laparoscopic pexy of the PD catheter to the abdominal wall to keep the catheter in an adhesion-free compartment is beneficial in selected patients. A future study with a larger number of patients is needed to further validate this strategy.

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Identification of the appropriate fixation site to avoid peritoneal catheter migration based on a mechanical analysis

Cited by 2 publications

References 19 publications

Wang's Forceps‐Assisted Percutaneous Insertion and Fixation of Peritoneal Dialysis Catheter

Wang's Forceps‐Assisted Percutaneous Insertion and Fixation of Peritoneal Dialysis Catheter

Laparoscopic-Assisted Abdominal Wall Pexy of Peritoneal Dialysis Catheter

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