Percutaneous insertion of peritoneal dialysis catheters by the nephrologist (modified Seldinger technique)
A proper functioning access to the peritoneal cavity is the first and foremost requirement to start peritoneal dialysis. Most commonly, peritoneal dialysis catheters are inserted using a surgical approach. Laparoscopic peritoneal dialysis catheter insertion is the recommended surgical technique because it offers to employ advanced adjunctive procedures that minimize the risk of mechanical complications. In patients with low risk of mechanical catheter complications, such as patients without prior history of abdominal surgery or peritonitis, and in patients ineligible for general anesthesia, the percutaneous approach of peritoneal dialysis catheter insertion is an alternative to surgical catheter insertion. Percutaneous insertion of peritoneal dialysis catheters can be performed by a dedicated nephrologist, interventional radiologist, surgeon or nurse practitioner under local anesthesia, either with or without image guidance using ultrasound or fluoroscopy. Several reports show similar catheter function rates, mechanical and infectious complications and catheter survival for percutaneously inserted peritoneal dialysis catheters compared to surgically inserted peritoneal dialysis catheters. This article describes the percutaneous insertion of peritoneal dialysis catheters technique adopted at Universitair Ziekenhuis Brussel since 2015. Our technique is a simple low-tech modified Seldinger procedure performed by the nephrologist and not using fluoroscopy guidance. We describe the excellent outcomes of our percutaneously inserted peritoneal dialysis catheters and offer a practical guide to set up your own percutaneous catheter insertion program.
Shrestha BM, Shrestha D, Kumar A, Shrestha A, Boyes SA, Wilkie ME. Advanced Laparoscopic Peritoneal Dialysis Catheter Insertion: Systematic Review and Meta-Analysis. Perit Dial Int 2018;38:163-71.
Abdel Aal AK, Guest SS, Moawad S, et al. Outcomes of fluoroscopic and ultrasound-guided placement versus laparoscopic placement of peritoneal dialysis catheters. Clinical kidney journal 2018;11:549-54.
Esagian SM, Sideris GA, Bishawi M, et al. Surgical versus percutaneous catheter placement for peritoneal dialysis: an updated systematic review and meta-analysis. Journal of nephrology 2020.
Khositrangsikun K, Chujohn W, Kanokkantapong C, Kanjanabuch T. Comparison of the Seldinger technique and surgical technique in Tenckhoff catheter insertion in CAPD patients: a single center experience. J Med Assoc Thai 2011;94 Suppl 4:S77-80.
Medani S, Shantier M, Hussein W, Wall C, Mellotte G. A comparative analysis of percutaneous and open surgical techniques for peritoneal catheter placement. Perit Dial Int 2012;32:628-35.
Xie D, Zhou J, Cao X, et al. Percutaneous insertion of peritoneal dialysis catheter is a safe and effective technique irrespective of BMI. BMC Nephrol 2020;21:199.
Kim JH, Kim MJ, Ye BM, et al. Percutaneous peritoneal dialysis catheter implantation with no break-in period: A viable option for patients requiring unplanned urgent-start peritoneal dialysis. Kidney Res Clin Pract 2020;39:365-72.
Nicholas J, Thomas M, Adkins R, et al. Percutaneous and surgical peritoneal dialysis catheter placements have comparable outcomes in the modern era. Perit Dial Int 2014;34:552-6.
Voss D, Hawkins S, Poole G, Marshall M. Radiological versus surgical implantation of first catheter for peritoneal dialysis: a randomized non-inferiority trial. Nephrol Dial Transplant 2012;27:4196-204.
Ozener C, Bihorac A, Akoglu E. Technical survival of CAPD catheters: comparison between percutaneous and conventional surgical placement techniques. Nephrol Dial Transplant 2001;16:1893-9.
Mellotte GJ, Ho CA, Morgan SH, Bending MR, Eisinger AJ. Peritoneal dialysis catheters: a comparison between percutaneous and conventional surgical placement techniques. Nephrol Dial Transplant 1993;8:626-30.
Atapour A, Asadabadi HR, Karimi S, Eslami A, Beigi AA. Comparing the outcomes of open surgical procedure and percutaneously peritoneal dialysis catheter (PDC) insertion using laparoscopic needle: A two month follow-up study. J Res Med Sci 2011;16:463-8.
Crabtree JH, Shrestha BM, Chow KM, et al. Creating and Maintaining Optimal Peritoneal Dialysis Access in the Adult Patient: 2019 Update. Perit Dial Int 2019;39:414-36.
Perl J, Pierratos A, Kandasamy G, et al. Peritoneal dialysis catheter implantation by nephrologists is associated with higher rates of peritoneal dialysis utilization: a population-based study. Nephrol Dial Transplant 2015;30:301-9.
Asif A. Peritoneal dialysis access-related procedures by nephrologists. Seminars in dialysis 2004;17:398-406.
Copyright (c) 2021 Karlien Francois
This work is licensed under a Creative Commons Attribution 4.0 International License.