Peritoneal Dialysis Catheter Placement Techniques

Peritoneal dialysis offers a home-based renal replacement therapy with advantages in quality of life and retention of residual renal function. The success of this therapy depends on secure and functional peritoneal dialysis catheter placement. Techniques can be broadly classified into open surgical placement, laparoscopic insertion, percutaneous approaches and image-guided interventional radiology methods. The open technique involves a small laparotomy and direct visualisation of the peritoneal cavity, requiring general anaesthesia and associated with higher incision-related morbidity. Laparoscopic placement employs minimally invasive ports and camera guidance to optimise catheter tip positioning, enable adjunctive procedures such as omentopexy and hernia repair, and reduce postoperative complications. Percutaneous insertion utilises needle-based access, often under ultrasound or fluoroscopic guidance, allowing rapid catheter deployment under local anaesthesia with reduced hospital stay. Interventional radiology approaches offer image-directed tunnelled catheter placement with tailored exit-site positioning and in-suite management of catheter malfunction. Innovations include fixation techniques such as omentopexy, advanced catheter designs and continuous quality improvement protocols to minimise leakage, migration and infection. The choice of method is influenced by patient characteristics, local expertise and resource availability, with global practice trends favouring minimally invasive and image-guided techniques for improved outcomes and patient satisfaction.

Research from Nature Portfolio

No recent Nature Portfolio content available.

Peritoneal Dialysis Catheter Placement Techniques publication trend

The graph below shows the total number of articles in peritoneal dialysis catheter placement techniques across all publications each year (not limited to Nature Index journals).

Technical terms

Peritoneal dialysis catheter: A flexible tube inserted into the peritoneal cavity to deliver and drain dialysis fluid.

Laparoscopic placement: Minimally invasive insertion of a catheter using small incisions and camera guidance.

Percutaneous insertion: Placement of a catheter through the skin via needle-based access under imaging guidance.

Seldinger technique: A method involving guidewire insertion through a needle, over which the catheter is advanced.

Omentopexy: Surgical fixation of the omentum away from the catheter tip to prevent obstruction.

Interventional radiology: Image-guided catheter placement and management performed by radiologists using modalities such as fluoroscopy.

References

1. Laparoscopic versus Open Peritoneal Dialysis Catheter Insertion: A Meta-Analysis. PLOS ONE (2013).
2. Ultrasound‐guided percutaneous peritoneal dialysis catheter insertion using multifunctional bladder paracentesis trocar: A modified percutaneous PD catheter placement technique. Seminars in Dialysis (2020).
3. Reducing the occurrence rate of catheter dysfunction in peritoneal dialysis: a single-center experience about CQI. Renal Failure (2018).
4. The Choice of Peritoneal Dialysis Catheter Implantation Technique by Nephrologists. International Journal of Nephrology (2013).
5. Prophylactic laparoscopic omentopexy: a new technique for peritoneal dialysis catheter placement. Renal Failure (2019).
6. Interventional Radiology Placement and Management of Tunneled Peritoneal Dialysis Catheters: A Pictorial Review. RadioGraphics (2020).