Skip to main content
Log in

A simple modified open peritoneal dialysis catheter insertion procedure reduces the need for secondary surgery

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



The aim of this retrospective study was to assess the efficacy of a modified peritoneal dialysis catheter insertion technique for reducing the incidence of mechanical complications.


We conducted a retrospective analysis of clinical data of 346 patients undergoing peritoneal dialysis catheter insertion at our peritoneal dialysis center. The traditional procedure was performed in 157 patients (group A) and the modified procedure in 189 patients (group B). The double-polyester-cuff straight Tenckhoff catheter was used in all patients.


At the end of 1 year, tunnel inflammation was more common in group A (21 patients after 0.011 patient-months follow-up versus 10 patients in group B after 0.007 patient-months of follow-up; p = 0.009). Technical survival rate of the catheter was significantly higher in group B (97.35% in group B vs. 89.81% in group A; p = 0.005). All-cause mortality was not significantly different between the two groups (4.5% in group A vs. 3.2% in group B; p = 0.532). Postoperative mechanical complications were also higher in group A (32 patients [20.4%] in group A vs. 3 patients [1.6%] in group B; p < 0.001). The incidences of complications such as hernia, dialysis fluid leakage, hemorrhage, incision infection, and prolapse of the polyester cuff were similar in the two groups.


The simple modified peritoneal dialysis catheter insertion procedure decreases the occurrence of catheter migration andomental encapsulation and improves the technical survival rate of the catheter.

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
Fig. 3

Similar content being viewed by others


  1. McCartan D et al (2015) Tenckhoff peritoneal dialysis catheter insertion in a Northern Ireland district general hospital. Ulster Med J 84(3):166–170

    PubMed  PubMed Central  Google Scholar 

  2. Gultekin FA et al (2013) Our long-term results of Tenckhoff peritoneal dialysis catheters placement via laparoscopic preperitoneal tunneling technique. Semin Dial 26(3):349–354

    Article  PubMed  Google Scholar 

  3. Garcia FT et al (1994) Complications of permanent catheter implantation for peritoneal dialysis: incidence and risk factors. Adv Perit Dial 10:206–209

    Google Scholar 

  4. E D et al (2009) Spring-back deformation in tube bending. Int J Miner Metall Mater 16(2):177–183

    Article  Google Scholar 

  5. Ahmed GMS et al (2014) Experimental evaluation of springback in mild steel and its validation using LS-DYNA. Procedia Mater Sci 6:1376–1385

    Article  CAS  Google Scholar 

  6. Zhang L et al (2011) Low-site peritoneal catheter implantation decreases tip migration and omental wrapping. Perit Dial Int 31(2):202–204

    PubMed  Google Scholar 

  7. Jiang C et al (2014) A modified open surgery technique for peritoneal dialysis catheter placement decreases catheter malfunction. Perit Dial Int 34(4):358–367

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Crabtree JH, Chow K (2017) Peritoneal dialysis catheter insertion. Semin Nephrol 37(1):17–29

    Article  PubMed  Google Scholar 

  9. Kume H et al (2011) Peritoneal fixation prevents dislocation of Tenckhoff catheter. Perit Dial Int 31(6):694–697

    Article  PubMed  Google Scholar 

  10. Hagen SM et al (2013) Laparoscopic versus open peritoneal dialysis catheter insertion: a meta-analysis. PLoS ONE 8(2):e56351

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Xie H et al (2012) Laparoscopic versus open catheter placement in peritoneal dialysis patients: a systematic review and meta-analysis. BMC Nephrol 13:69

    Article  PubMed  PubMed Central  Google Scholar 

  12. Strippoli GF et al (2004) Catheter-related interventions to prevent peritonitis in peritoneal dialysis: a systematic review of randomized, controlled trials. J Am Soc Nephrol 15(10):2735–2746

    Article  PubMed  Google Scholar 

  13. Yip T, Lui SL, Lo WK (2013) The choice of peritoneal dialysis catheter implantation technique by nephrologists. Int J Nephrol 2013:940106

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Jwo SC et al (2010) Prospective randomized study for comparison of open surgery with laparoscopic-assisted placement of Tenckhoff peritoneal dialysis catheter—a single center experience and literature review. J Surg Res 159(1):489–496

    Article  PubMed  Google Scholar 

  15. Peppelenbosch A et al (2008) Peritoneal dialysis catheter placement technique and complications. NDT Plus 1(Suppl 4):iv23–iv28

    PubMed  PubMed Central  Google Scholar 

  16. Al-Hwiesh AK (2014) Percutaneous peritoneal dialysis catheter insertion by a nephrologist: a new, simple, and safe technique. Perit Dial Int 34(2):204–211

    Article  PubMed  PubMed Central  Google Scholar 

  17. Chula DC et al (2014) Percutaneous and surgical insertion of peritoneal catheter in patients starting in chronic dialysis therapy: a comparative study. Semin Dial 27(3):E32–E37

    Article  PubMed  Google Scholar 

  18. Zappacosta AR, Perras ST, Closkey GM (1991) Seldinger technique for Tenckhoff catheter placement. ASAIO Trans 37(1):13–15

    Article  CAS  PubMed  Google Scholar 

  19. Hagen SM et al (2014) A systematic review and meta-analysis of the influence of peritoneal dialysis catheter type on complication rate and catheter survival. Kidney Int 85(4):920–932

    Article  PubMed  Google Scholar 

  20. Xie J et al (2011) Coiled versus straight peritoneal dialysis catheters: a randomized controlled trial and meta-analysis. Am J Kidney Dis 58(6):946–955

    Article  PubMed  Google Scholar 

  21. Johnson DW et al (2006) A randomized controlled trial of coiled versus straight swan-neck Tenckhoff catheters in peritoneal dialysis patients. Am J Kidney Dis 48(5):812–821

    Article  PubMed  Google Scholar 

  22. Bergamin B et al (2010) Finding the right position: a three-year, single-center experience with the “self-locating” catheter. Perit Dial Int 30(5):519–523

    Article  PubMed  Google Scholar 

  23. Stegmayr BG et al (2015) Few outflow problems with a self-locating catheter for peritoneal dialysis: a randomized trial. Medicine (Baltimore) 94(48):e2083

    Article  Google Scholar 

  24. Di Paolo N et al (2004) The self-locating catheter: clinical experience and follow-up. Perit Dial Int 24(4):359–364

    PubMed  Google Scholar 

  25. Moreiras-Plaza M et al (2014) New peritoneal catheters: new catheter problems? Perit Dial Int 34(5):556–561

    Article  PubMed  PubMed Central  Google Scholar 

  26. Minguela I et al (2001) Lower malfunction rate with self-locating catheters. Perit Dial Int 21(Suppl 3):S209–S212

    PubMed  Google Scholar 

Download references


We thank our operation team and PD nursing team for their able assistance. This work was supported by Guangdong Provincial Natural Science Foundation (Grant No. 2016A030310193).

Author information

Authors and Affiliations


Corresponding author

Correspondence to Weiping Zhu.

Ethics declarations


The authors have nothing to disclose.

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

Li, Y., Zhu, Y., Liang, Z. et al. A simple modified open peritoneal dialysis catheter insertion procedure reduces the need for secondary surgery. Int Urol Nephrol 51, 729–736 (2019).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: