Ultrasound‐guided percutaneous peritoneal dialysis catheter insertion using multifunctional bladder paracentesis trocar: A modified percutaneous PD catheter placement technique

Abstract

Background To evaluate the efficacy and safety of ultrasound‐guided percutaneous peritoneal dialysis catheter insertion using multifunctional bladder paracentesis trocar. Methods A retrospective review of 103 ESRD patients receiving percutaneous PD catheter insertion using a multifunctional bladder paracentesis trocar under ultrasound guidance at a single center between May 2016 and May 2018. Mechanical complications and catheter survival were evaluated over a 12‐month follow‐up. Result Catheterization using this technique required only 10‐30 minutes from the beginning of local anesthesia to the end of skin suture at the puncture site (mean 18 ± 7 minutes) and an incision length of 2‐4 cm. Moreover, only four of 103 cases required catheter removal due to poor drainage within one month after surgery, with a success rate of 96.19%. Among failures, omentum wrapping was cause in two cases, catheter displacement in one case, and protein clot blockage in one case, while there were no instances of organ injury, severe hemorrhage, peritubular leakage, hernia, peritonitis, or exit infection within one month of PD catheter insertion. Catheter survival at 1 year was 92.2%. Conclusion Percutaneous PD catheter insertion using a multifunctional bladder paracentesis trocar and ultrasound guidance is a feasible technique for ESRD patients.

Assessment of complications and short-term outcomes of percutaneous peritoneal dialysis catheter insertion by conventional or modified Seldinger technique

“…About 5% of patients even without a previous history of abdominal surgery can also have adhesions [ 23 ]. If there is relatively free movement of the small bowel by transabdominal ultrasound, the probability of significant adhesions is low, thereby reducing the risk of intraoperative bowel injury [ 24 , 25 ].…”

Association between different peritoneal dialysis catheter placement methods and short‐term postoperative complications

“…The sheath was torn from both sides until all parts lower than the polyester sheath in the peritoneal dialysis catheter entered. The peritoneal fluid drainage was unobstructed [ 17 , 22 , 23 ].…”

Changing the peritoneal dialysis access algorithm with a precise technique of percutaneous Seldinger PD catheter placement

“…Seldinger PD catheter placement is at least 20 years old, and there have been numerous publications, mostly of small case series, in a variety of Specialty Journals. 6–9 There is great variation in the techniques and equipment used, from completely blind peritoneal puncture without the use of ultrasound or X-ray guidance to the techniques described by Interventional Radiologists which are most similar to those used in our series. 10…”

“…Seldinger PD catheter placement is at least 20 years old, and there have been numerous publications, mostly of small case series, in a variety of Specialty Journals. [6][7][8][9] There is great variation in the techniques and equipment used, from completely blind peritoneal puncture without the use of ultrasound or X-ray guidance to the techniques described by Interventional Radiologists which are most similar to those used in our series. 10 Our technique uses, in all cases, pre-procedure PD catheter mapping, ultrasound guidance for peritoneal access and radiological guidance -both plain X-ray and contrast peritoneography -for sheath establishment and accurate catheter tip placement.…”