HA HAKIM1, S DHEDA1, V LEE1, D PRATT1, M MANTHA1
1Cairns Hospital, Cairns,, Australia
Background: The success of peritoneal dialysis depends on a well-functioning peritoneal dialysis (PD) catheter. Both open surgical or laparoscopic techniques that allow rectus sheath tunnelling, adhesiolysis and omentopexy are resource intense and timely access to them is difficult. Ultrasound and fluoroscopy guided placement of PD catheter is minimally invasive and appears to be equivalent to laparoscopic surgical placement but anchoring the deep cuff in to the rectus muscle is difficult with this method.
Aim: We report our initial experience of a simple percutaneous PD catheter insertion technique through linea-alba obviating the need for deep cuff placement in the rectus muscle, hence minimising the discomfort and trauma.
Methods: All patients who underwent ultrasound and fluoroscopy guided Tenchoff insertion between 1st January 2017 and 31 March 2018 at Cairns Hospital were included.
Medical records of all identified cases were reviewed to collect data with regards to catheter-related information including insertion dates, commencement of PD and early complications (first 30 days of insertion) including PD peritonitis, exit site infections, leaks and catheter malfunction.
Results: Twenty-six patients had Argyle (™) curled tip PD catheters inserted under radiological guidance during the study period. Early complications occurred in 16% of catheters, including 2 episodes of peri catheter leak (7.6%) which did not require surgical intervention, 1 episode of peritonitis (3.8%) and 1 case of early exit site infection (3.8%). There were no cases of early catheter migration or primary malfunction.
Conclusion: The Seldinger technique of percutaneous peritoneal catheter insertion through linea-alba is an effective and simple procedure with a desirable technical success and complication rates.
Consultant Nephrologist at Cairns hospital with clincal interests in home therapies, vascular access and interventional nephrology.