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.
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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
Fresenius medical care (2015) Fresenius medical care 2015 annual report: ESRD patients in 2015: A global perspective
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
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
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
Crabtree JH, Chow KM (2017) Peritoneal dialysis catheter insertion. SeminNephrol 37(1):17–29
Maya ID (2007) Ultrasound/fluoroscopy-assisted placement of peritoneal dialysis catheters. Semin Dial 20(6):611–615
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
Peters CA (1996) Complications in pediatric urological laparoscopy: results of a survey. J Urol 155(3):1070–1073
Yanke BV, Horowitz M (2007) Safety of the Veress needle in pediatric laparoscopy. J Endourol 21(7):695–697
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
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
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
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
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
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).
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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.
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This study was approved by institutional ethics review board of the hospital (reference number: 2018-R057).
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Written informed consent was obtained from all individual participants of the modified group.
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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
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DOI: https://doi.org/10.1007/s11255-020-02769-4