Peritoneal dialysis catheter

Tenckhoff catheter

Principles

• Relies on solute flow across the peritoneum to allow for dialysis of waste products
• Different areas of peritoneum contribute differently
• Loss of significant visceral peritoneum (large small bowel resection or colectomy) may only reduce filtration by 10-20%

Technique

• LUQ cut-down/optical entry
• Additional 5mm port for manipulation
• Entry site 3cm lateral to umbilicus
• Insert pull-apart sheath and then catheter, angling down towards pelvis. Try to tunnel it within the abdominal wall, so the defects in anterior and posterior fascia are not superimposed.
• Pull the sheath apart, keeping the catheter in place
• Tunnel the external part of tubing to LUQ
• Close up