Skip to main content
Log in

From “feeling” to “seeing”: modification of the percutaneous peritoneal dialysis catheter insertion with an optical puncture system

  • Nephrology - Original Paper
  • Published:
International Urology and Nephrology Aims and scope Submit manuscript

Abstract

Purpose

Blind insertion limits the application of percutaneous peritoneal dialysis (PD) catheter placement. In this study, we first described the use of an optical puncture system in the PD catheter insertion, and investigated the feasibility and advantages of this modified technique.

Methods

This retrospective study included 65 patients with chronic kidney disease stage 5 (CKD5) who received ultrasound-guided percutaneous PD catheter insertion with or without optical puncture system assistance between June 2018 and July 2019. The patients’ characteristics as well as the surgical outcomes and complications were compared between the modified group and the routine percutaneous insertion group.

Results

Twenty-five patients underwent optical puncture system assistant insertion, whereas 40 patients received routine percutaneous insertion. More patients had previous abdominal surgical histories in the modified group than those in the routine group (24.0% vs. 5.0%, p = 0.047). The time of accessing to the abdominal cavity was significantly shorter in the modified group (median [IQR]; 1.1 min [0.8–1.3] vs. 5.0 min [4.0–6.0]; p < 0.001). Meanwhile, the time of the whole procedure was also significantly shorter in the modified group (median [IQR]; 26.0 min [25.0–29.0] vs. 33.0 min [29.0–35.0]; p < 0.001). None of the patient in the modified group, while two patients (5.0%) in the routine group converted to open procedure. There were no significant differences in the short and long postoperative complications between the two groups.

Conclusions

The operation of ultrasound-guided PD catheter placement with the optical puncture system is easy, safe, fast and accurate, whereby the PD catheter can be implanted percutaneously and visually under local anesthesia with minimal procedure-related complications. The visible puncture of the optical puncture system may facilitate ultrasound-guided percutaneous PD catheter insertion in patients with obesity and previous abdominal surgeries.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

Availability of data and materials

The datasets used or analyzed during the current study are available from the corresponding author on reasonable request.

Code availability

Not applicable.

References

  1. Fresenius medical care (2015) Fresenius medical care 2015 annual report: ESRD patients in 2015: A global perspective

  2. Li PK, Chow KM, Van de Luijtgaarden MW, Johnson DW, Jager KJ, Mehrotra R et al (2017) Changes in the worldwide epidemiology of peritoneal dialysis. Nat Rev Nephrol 13(2):90–103

    Article  CAS  Google Scholar 

  3. Troidle L, Kliger A, Finkelstein F (2006) Barriers to utilization of chronic peritoneal dialysis in network #1, New England. Perit Dial Int 26(4):452–457

    Article  Google Scholar 

  4. Asif A, Byers P, Gadalean F, Roth D (2003) Peritoneal dialysis underutilization: the impact of an interventional nephrology peritoneal dialysis access program. Semin Dial 16(3):266–271

    Article  Google Scholar 

  5. Crabtree JH, Chow KM (2017) Peritoneal dialysis catheter insertion. SeminNephrol 37(1):17–29

    Google Scholar 

  6. Maya ID (2007) Ultrasound/fluoroscopy-assisted placement of peritoneal dialysis catheters. Semin Dial 20(6):611–615

    Article  Google Scholar 

  7. Bader MJ, Gratzke C, Seitz M, Sharma R, Stief CG, Desai M (2011) The “all-seeing needle”: initial results of an optical puncture system confirming access in percutaneous nephrolithotomy. EurUrol 59(6):1054–1059

    Google Scholar 

  8. Silay MS, Tepeler A, Sancaktutar AA, Kilincaslan H, Altay B, Erdem MR et al (2013) The all-seeing needle instead of the Veress needle in pediatric urologic laparoscopy. J Endourol 27(11):1376–1380

    Article  Google Scholar 

  9. Maio R, Figueiredo N, Costa P (2008) Laparoscopic placement of Tenckhoff catheters for peritoneal dialysis: a safe, effective, and reproducible procedure. Perit Dial Int 28(2):170–173

    Article  Google Scholar 

  10. Chula DC, Campos RP, de Alcantara MT, Riella MC, do Nascimento MM (2014) Percutaneous and surgical insertion of peritoneal catheter in patients starting in chronic dialysis therapy: a comparative study. Semin Dial 27(3):E32-37

    Article  Google Scholar 

  11. Sun TY, Voss D, Beechey D, Lam-Po-Tang M (2016) Comparison of peritoneal dialysis catheter insertion techniques: peritoneoscopic, radiological and laparoscopic: a single-centre study. Nephrology (Carlton) 21(5):416–422

    Article  Google Scholar 

  12. Shahbandari M, Amiran A (2019) Comparison of the complications of open surgery versus laparoscopic technique in insertion of peritoneal dialysis catheter. J Res Med Sci 24:85

    Article  Google Scholar 

  13. Tullavardhana T, Akranurakkul P, Ungkitphaiboon W, Songtish D (2016) Surgical versus percutaneous techniques for peritoneal dialysis catheter placement: a meta-analysis of the outcomes. Ann Med Surg (Lond) 10:11–18

    Article  Google Scholar 

  14. Zhu W, Jiang C, Zheng X, Zhang M, Guo H, Yan X (2015) The placement of peritoneal dialysis catheters: a prospective randomized comparison of open surgery versus “Mini-Perc” technique. Int UrolNephrol 47(2):377–382

    CAS  Google Scholar 

  15. Zhu W, Jiang C, Yan X, Sun C, Zhang M (2013) The ureteroscope-assisted “Mini-Perc” technique of placement of peritoneal dialysis catheters with a 16-Fr Peel-Away sheath: 3-year results in 47 patients. Int UrolNephrol 45(1):233–237

    Google Scholar 

  16. Hu JC, Chiu KY, Wang SS, Chen CS, Ho HC, Yang CK et al (2018) A modified application of peritoneal dialysis catheter implantation: a revolution from the laparoscope- to the nephroscope-assisted surgery. J Endourol 32(6):502–508

    Article  Google Scholar 

  17. Li Z, Ding H, Liu X, Zhang J (2020) Ultrasound-guided percutaneous peritoneal dialysis catheter insertion using multifunctional bladder paracentesis trocar: a modified percutaneous PD catheter placement technique. Semin Dial 33(2):133–139

    Article  Google Scholar 

  18. Crabtree JH, Shrestha BM, Chow KM, Figueiredo AE, Povlsen JV, Wilkie M et al (2019) Creating and maintaining optimal peritoneal dialysis access in the adult patient: 2019 update. Perit Dial Int 39(5):414–436

    Article  Google Scholar 

  19. Asif A, Byers P, Vieira CF, Merrill D, Gadalean F, Bourgoignie JJ et al (2003) Peritoneoscopic placement of peritoneal dialysis catheter and bowel perforation: experience of an interventional nephrology program. Am J Kidney Dis 42(6):1270–1274

    Article  Google Scholar 

  20. Abdel-Aal AK, Dybbro P, Hathaway P, Guest S, Neuwirth M, Krishnamurthy V (2014) Best practices consensus protocol for peritoneal dialysis catheter placement by interventional radiologists. Perit Dial Int 34(5):481–493

    Article  Google Scholar 

  21. Wang H, Wang Y, Zhu J, Chen X, Chen C, Xiang C et al (2018) Wang’s forceps-assisted percutaneous insertion and fixation of peritoneal dialysis catheter. Artif Organs 42(7):728–735

    Article  Google Scholar 

  22. Asif A, Tawakol J, Khan T, Vieira CF, Byers P, Gadalean F et al (2004) Modification of the peritoneoscopic technique of peritoneal dialysis catheter insertion: experience of an interventional nephrology program. Semin Dial 17(2):171–173

    Article  Google Scholar 

  23. Azevedo JL, Azevedo OC, Miyahira SA, Miguel GP, Becker OM Jr, Hypolito OH et al (2009) Injuries caused by Veress needle insertion for creation of pneumoperitoneum: a systematic literature review. SurgEndosc 23(7):1428–1432

    Google Scholar 

  24. Peters CA (1996) Complications in pediatric urological laparoscopy: results of a survey. J Urol 155(3):1070–1073

    Article  CAS  Google Scholar 

  25. Yanke BV, Horowitz M (2007) Safety of the Veress needle in pediatric laparoscopy. J Endourol 21(7):695–697

    Article  Google Scholar 

  26. Thomas MA, Rha KH, Ong AM, Pinto PA, Montgomery RA, Kavoussi LR et al (2003) Optical access trocar injuries in urological laparoscopic surgery. J Urol 170(1):61–63

    Article  Google Scholar 

  27. Riar S, Abdulhadi M, Day C, Prasad B (2018) Accidental insertion of a peritoneal dialysis catheter in the urinary bladder. Case Rep Nephrol Dial 8(1):76–81

    Article  Google Scholar 

  28. Desai MR, Sharma R, Mishra S, Sabnis RB, Stief C, Bader M (2011) Single-step percutaneous nephrolithotomy (microperc): the initial clinical report. J Urol 186(1):140–145

    Article  Google Scholar 

  29. Tepeler A, Armagan A, Sancaktutar AA, Silay MS, Penbegul N, Akman T et al (2013) The role of microperc in the treatment of symptomatic lower pole renal calculi. J Endourol 27(1):13–18

    Article  Google Scholar 

  30. Xiao B, Diao X, Jin S, Ji C, Zhang G, Su B et al (2020) A novel surgical technique for treatment of renal stones in preschool-aged patients: initial experience with Needle-perc. Urology. https://doi.org/10.1016/j.urology.2020.07.055

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The authors gratefully acknowledge the funding of the Medical and Health Science and Technology Plan Project of Zhejiang Province of China (No. 2019KY167, No.2020PY067) for this study.

Funding

This work was funded by the Medical and Health Science and Technology Plan Project of Zhejiang Province (No. 2019KY167, No.2020PY067).

Author information

Authors and Affiliations

Authors

Contributions

Research idea: XJ, JH (contributed equally); study design: ZY, QM; surgical procedure: XJ, JH, GX, XB; data acquisition and analysis: DZ, JJ; supervision or mentorship: XB and YC (contributed equally). Each author contributed important intellectual content during manuscript drafting or revision and accepts accountability for the overall work by ensuring that questions pertaining to the accuracy or integrity of any portion of the work are appropriately investigated and resolved.

Corresponding authors

Correspondence to Xueyan Bian or Yue Cheng.

Ethics declarations

Conflict of interest

The authors have no conflicts of interest to declare.

Ethics approval

This study was approved by institutional ethics review board of the hospital (reference number: 2018-R057).

Consent to participate

Written informed consent was obtained from all individual participants of the modified group.

Consent for publication

Written informed consent for publication was obtained from all participants included in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Jia, X., Huang, J., Xie, G. et al. From “feeling” to “seeing”: modification of the percutaneous peritoneal dialysis catheter insertion with an optical puncture system. Int Urol Nephrol 53, 1239–1245 (2021). https://doi.org/10.1007/s11255-020-02769-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11255-020-02769-4

Keywords

Navigation