Charbel Aoun*, Saleem Abdelbacki, Alexandre Malek, Marilyn Khoury and Mansour El Khoury
Department of General Surgery, Saint Georges Hospital University Medical Center, University of Balamand, LebanonFulltext PDF
Introduction: The technique for Peritoneal Dialysis (PD) catheter placement is essential to the
success of the renal replacement therapy through peritoneal dialysis. Our technique can reduce
dialysis failure by decreasing the risk of catheter complications.
Catheter type and design: There are several shapes of PD catheters including pigtail curled, straight,
and swan neck. In our technique, we used the pigtail-curled catheter.
Technique of implantation and surgical technique: The preferred techniques are open surgical and
laparoscopic due to their good initial results and safety. Our new open surgical technique provides
the advantages of being done under local anesthesia, fast, small sized incision, and the early use of
the catheter for dialysis with low risk of fluid leakage.
Complications: After the procedure, complications are defined as early if less than 30 days or late
if more than 30 days. Early complications include bowel perforation, bleeding, wound infection,
outflow failure, or leakage of the dialysate. Late complications involve outflow failure, cuff
protrusion, tunnel or exit-site infection, and hernia or dialysate leaks.
Conclusion: The advantage of our open surgical technique is its simplicity and its ability to be
operated under local anesthesia. It requires fewer skills, so it is easier for surgical residents.
Postoperatively less dialysate leakage due to the closure of the peritoneum and the rectus sheaths. In
addition, the suture fixation of the catheter to the retropubic peritoneum prevents kinking, catheter
displacement, or occlusion of the catheter by the omentum.
Aoun C, Abdelbacki S, Malek A, Khoury M, El Khoury M. New Surgical Technique for Peritoneal Dialysis Catheter Placement: Early Peritoneal Dialysis and Catheter Migration Prevention. World J Surg Surgical Res. 2020; 3: 1256..