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



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.


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.


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.


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.

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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.


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

Author information




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.

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

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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 (2021).

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  • Peritoneal dialysis
  • Catheter
  • Modification
  • Percutaneous
  • Optical puncture system