Peritoneal Dialysis Catheter Placement: Percutaneous and Peritoneoscopic Techniques

Abstract

Chronic peritoneal dialysis (PD) is an underutilized renal replacement therapy in treating end-stage renal disease that has several advantages over hemodialysis. The success of continuous ambulatory PD is largely dependent on a functional long-term access to the peritoneal cavity. Several methods have been developed to place the PD catheter using both surgical and percutaneous techniques. The purpose of this article is to describe the percutaneous techniques using fluoroscopy guidance and peritoneoscope method. While fluoroscopic method uses fluoroscopy guidance and a guidewire to place the PD catheter, the peritoneoscopic technique utilizes a needlescope to directly visualize the peritoneal space to avoid adhesions and omentum during catheter placement. These percutaneous approaches are minimally invasive procedures that can be performed on an outpatient basis without the need for general anesthesia.

Outcomes of Percutaneous Peritoneal Dialysis Catheters Insertion by Interventional Radiologists: A Single-Institution Experience

“…5,6 PD catheter insertion, whether surgical or percutaneous, has been subjected to constant developments. 3 PD insertion technique is determined by several factors, including patient comorbidities, health care provider's expertise, resource availability, and urgency for PD initiation. 7 Imageguided percutaneous PD insertion by vascular and interventional radiologists offers scheduling efficiencies and cost-effectiveness with relatively speedy recovery due to the percutaneous minimally invasive nature of catheter placement.…”

“…1 Statistically, Saudi Arabia (2020) reported 28,769 RRT patients, of them only 1,781 patients on PD. 2 Unlike facility-based hemodialysis, 3 PD as an option of home-based dialysis offers unique lifestyle benefits by increasing patient autonomy, facilitating mobility, and lowering dialysis costs. 4 In addition, improving patient-reported satisfactory outcomes.…”

“…8 The continuity of well-functioning PD primarily depends on proper insertion technique and meticulous postprocedural maintenance. 1,3 This begins with a preoperative evaluation to select the best candidates, determine the most applicable catheter configuration type, and determine both entry and anatomical exit sites. Proper planning and patient counseling facilitate performing the procedure, lower the risk of all mechanical and infectious complications, and allow permanent functional access for dialysis.…”

“…Proper planning and patient counseling facilitate performing the procedure, lower the risk of all mechanical and infectious complications, and allow permanent functional access for dialysis. 1,3,4 These complications, which are directly related to the PD insertion procedure, usually cause catheter failure and lead to substantial morbidity and mortality. 9 This study was carried out to evaluate the short-and longterm outcomes of percutaneous PD catheters inserted by interventional radiology service and analyze the factors that affect the sustainability of patent and functional PD catheters.…”

“…Proper planning and patient counseling facilitate performing the procedure, lower the risk of all mechanical and infectious complications, and allow permanent functional access for dialysis. 1 3 4 These complications, which are directly related to the PD insertion procedure, usually cause catheter failure and lead to substantial morbidity and mortality. 9…”