F. Entabi1,2, F. Entabi, MD1,2 1University Of California – Davis,Sacramento, CA, USA 2Entabi, MD Inc.,Tulare, CA, USA
Introduction: Peritoneal dialysis is on the rise around the world. However, PDC insertion has been the limiting step, as it requires an operating room or an interventional radiology suite. We examined a new method of inserting a PDC that simplifies the procedure and makes it possible to be done at an office without imaging guidance.
Methods: 48 consecutive patients were studied in a prospective fashion from 2013 until 2017. The only exclusion criterion was a pre-existing hernia. In which case, a hernia repair was done at the same time as the catheter insertion. 40 patients had PDC inserted using our technique; 23 of them were done at the office, the rest were done at the hospital. Our technique utilizes a disposable Veress type configuration combined with the Seldinger method to insert the catheter.
Results:
No organ injuries were encountered. 69% of patients were started on peritoneal dialysis within 2 weeks from insertion. No leaks were encountered. Only one local infection was identified within 60 days of insertion and was successfully treated with antibiotics. We did not have to replace any catheters. One procedure was aborted due to severe pain.?
Conclusion:
PDC insertion in the office under local anesthesia without imaging is safe when using the appropriate instruments. It allows early start of peritoneal dialysis, reduces the cost and time of PDC insertion. In addition, it has the potential to save millions of lives in developing countries where no access to operating rooms or imaging equipment is available.?