Application of Seldinger's Percutaneous Method to Peritoneal Dialysis

Abstract

PERITONEAL dialysis is an accepted method of management of acute and chronic renal failure, endogenous and exogenous intoxication, as well as intractable heart failure and edema.15The present technique, as described by Maxwell et al,6involves the introduction of a plastic catheter through a trocar of greater diameter into the peritoneal cavity. Its shortcomings include leakage of dialyzing fluid around the catheter through the unnecessarily larger puncture wound,6intraperitoneal infection secondary to the leakage,7and hemorrhage resulting from the trauma of a large trocar. Seldinger's percutaneous method,8widely used in vascular catheterization, minimizes these undesirable effects. According to this method, a small trocar is introduced into the peritoneal cavity and a flexible guide wire is advanced through it; after the trocar is removed, a catheter is slipped over the guide wire which is then withdrawn, leaving the catheter firmly in place. Method We have used