Peritoneal Dialysis Catheter Placement

What is Peritoneal Dialysis Catheter Placement

Peritoneal dialysis catheter placement is a surgery to insert a thin, flexible tube (catheter) into the abdomen. The catheter will be used for peritoneal dialysis, which is a process for filtering the blood.

The catheter will be small, soft, and easy to conceal. The catheter placement is usually done at least 2 weeks before peritoneal dialysis is started.

During dialysis, wastes, salt, and extra water are removed from the blood. In peritoneal dialysis, these tasks are performed by transferring a fluid (dialysate) to and from the abdomen during each session. The fluid goes through the catheter to enter the abdomen at the start of each dialysis session, and it drains out of the body through the catheter at the end of each session.

This procedure will be done using one of the following techniques:

  • Open technique. This is when the surgery is performed through one incision.
  • Laparoscopic technique. This is when smaller incisions are made and a tube with a light and camera on the end (laparoscope) is inserted through one of the incisions to help perform the surgery. The camera sends images to a video screen in the operating room. This lets the surgeon see inside the abdomen during the procedure.

Tell a health care provider about:

  • Any allergies you have.
  • All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
  • Any problems you or family members have had with anesthetic medicines.
  • Any blood disorders you have.
  • Any surgeries you have had.
  • Any history of smoking.
  • Any medical conditions you have.
  • Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

  • Infection.
  • Too much bleeding.
  • A collection of blood near the incision (hematoma).
  • Damage to blood vessels, tissues, or organs in the abdomen area.
  • Allergic reactions to medicines.
  • Pain or cramping.
  • Slow healing.
  • Catheter problems after the surgery, such as:
    • The catheter becoming blocked.
    • The catheter moving out of place.
    • The catheter poking into or wrapping around intestines.
    • Fluid leaking around the catheter.
  • Scarring.
  • Skin damage.

What happens before the procedure?

Medicines

Ask your health care provider about:

  • Changing or stopping your regular medicines. This is especially important if you take diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines before your procedure if your health care provider tells you not to.

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

  • Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

Follow instructions from your health care provider about eating and drinking, which may include:

  • 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
  • 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
  • 6 hours before the procedure – stop drinking milk or drinks that contain milk.
  • 2 hours before the procedure – stop drinking clear liquids.

General instructions

  • Ask your health care provider how your catheter site will be marked or identified. Your health care provider will discuss the best site for the catheter to be placed. The site will be chosen to help prevent the catheter from being flattened or damaged, and to make it as comfortable as possible for you.
  • You may be asked to shower with a germ-killing soap.
  • You may have a CT scan of your abdomen.
  • You may have a blood sample taken.
  • Plan to have someone take you home from the hospital or clinic.

What happens during the procedure?

  • To lower your risk of infection:
    • Your health care team will wash or sanitize their hands.
    • Your skin will be washed with soap.
    • Hair may be removed from the surgical area.
  • An IV will be inserted into one of your veins.
  • You may be given antibiotic medicine through your IV.
  • You will be given a medicine to make you fall asleep (general anesthetic).
  • If you are having an open surgery, one larger incision will be made in the abdomen.
  • If you are having laparoscopic surgery, a laparoscope and instruments will be put through small incisions in the abdomen.
  • The catheter will be put in place.
  • A short tunnel will be made under the skin to a location where the catheter exits the abdomen.
  • Stitches (sutures) will be placed around the catheter to hold it in place.
  • Your incisions will be closed with sutures or staples.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

  • Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until the medicines you were given have worn off.
  • You may have some pain. You will be given pain medicine as needed.
  • You will be given instructions about how to care for your catheter and how it is used for the dialysis process.

Summary

  • Peritoneal dialysis catheter placement is a surgery to insert a thin, flexible tube (catheter) in your abdomen. This surgery must be done before you begin peritoneal dialysis.
  • Before the procedure, your health care provider will discuss the best site for the catheter to be placed. The site will be chosen to help prevent the catheter from being flattened or damaged, and to make it as comfortable as possible for you.
  • After the procedure, you will be given instructions about how to care for your catheter and how it is used for the dialysis process.

Peritoneal Dialysis Catheter Placement, Care After

This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

  • After the procedure, it is common to have some pain or discomfort in your abdomen, your incision area, or both.
  • You may need to wait 2 weeks after your procedure before you can start peritoneal dialysis treatment. If you need dialysis before that time, your health care provider may begin peritoneal dialysis treatment early or offer kidney dialysis treatments (hemodialysis) until you heal.

Follow these instructions at home:

Incision care

  • Follow instructions from your health care provider about how to take care of your incision(s). Make sure you:
    • Change your dressing only as told by your health care provider. Your health care provider may tell you to not touch or change your dressing.
    • Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
    • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for two weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do not remove adhesive strips completely unless your health care provider tells you to do that.
  • Check your incision area(s) every day for signs of infection. (If you were instructed to not touch or change your dressing, look at your dressing for signs of infection.) Check for:
    • Redness, swelling, or more pain.
    • Fluid or blood.
    • Warmth.
    • Pus or a bad smell.

Medicines

  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • If you were prescribed an antibiotic medicine, take it as told by your health care provider. Do not stop using the antibiotic even if your condition improves.

Driving

  • Do not drive or ride in a car until your health care provider approves. Your seat belt could move the catheter out of position or cause irritation by rubbing on your incision.
  • Do not drive or use heavy machinery while taking prescription pain medicine.

Activity

  • Rest and limit your activity. Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
  • Do not lift anything that is heavier than 10 lb (4.5 kg), or the limit that you are told, until your health care provider says that it is safe.

Preventing constipation

  • To prevent or treat constipation, your health care provider may recommend that you:
    • Take over-the-counter or prescription medicines.
    • Eat foods that are high in fiber, such as fresh fruits and vegetables, whole grains, and beans.
    • Limit foods that are high in fat and processed sugars, such as fried and sweet foods.

General instructions

  • Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
  • Follow instructions from your health care provider about eating or drinking restrictions.
  • Do not take baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider if you may take showers. You may only be allowed to take sponge baths.
  • Wear loose-fitting clothing that keeps the catheter covered so that it cannot get caught on something.
  • Keep your catheter clean and dry.
  • Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

  • You have a fever.
  • You have redness, swelling, or more pain around an incision.
  • You have fluid or blood coming from an incision.
  • An incision feels warm to the touch.
  • You have pus or a bad smell coming from an incision.
  • You cannot eat or drink without vomiting.

Get help right away if:

  • You have problems breathing.
  • You are confused.
  • You have trouble speaking.
  • You have severe pain in your abdomen that does not get better with treatment.
  • You have bright red blood in your stool (feces), or your stool is dark black and looks like tar.

These symptoms may represent a serious problem that is an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services (911 in the U.S.). Do not drive yourself to the hospital.

Summary

  • After the procedure, it is common to have some pain or discomfort in your abdomen, your incision, or both.
  • You may have to wait 2 weeks after your procedure before you can start peritoneal dialysis treatment.
  • Check your incision area(s) every day for signs of infection.
  • Get medical help right away if you have severe pain in your abdomen that does not get better with treatment.
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