T Tenckhoff catheter (TC), first introduced in 1968, remains the basic prototype of a peritoneal access for peritoneal dialysis (PD). However, various complications caused by the use of TC, which include pericatheter leakage of fluids, catheter migration, outflow obstruction, and exit-site infections, result in technique failure in PD. To avoid such complications, developments in peritoneal catheters—from new designs to changes in the insertion techniques—have been described. In this issue, 4 articles illustrate such advances in PD access. The second article covers the 10 years of progress of the presternal PD catheter, a modified swan neck catheter introduced by Twardowski. Instead of an abdominal exit site, this catheter has an exit site at the sternum to decrease the risk of exit-site infection. The presternal catheters are particularly useful in obese patients (with body mass index 35), patients with ostomies, patients who enjoys tub bathing, and pediatric patients. Moncrief and Popovich introduced a new catheter in 1990 (another modified swan neck catheter) and a new insertion technique to reduce catheter related infections from bacterial adherence to catheter surfaces during implantation. In this novel method of catheter implantation, at insertion the subcutaneous part of the catheter is left embedded for 4 to 6 weeks under the skin. This allows tissue cells to colonize the catheter surface and the external cuff (which is elongated for more tissue attachment) and produce a bacterial barrier from the exit wound. The catheter is exteriorized, when the patient needs dialysis to be started, in an out patient surgical procedure. Recent data indicate that this new technique of catheter implantation increases catheter life expectancy and reduces exit-site infections The first article in this series deals with the outcome of this new technique which is becoming accepted as a simple, safe, and costeffective procedure for quality improvement of PD patients around the world. Recently, a new catheter (Ash Advantage) has been introduced as a suitable alternative PD access device for patients having problems with a previous TC. This new catheter is a “T”-shaped, fluted abdominal tube and can be inserted by peritoneoscopy or laparoscopy. Preliminary clinical data, described in the third article of the series, by Dr Ash et al, indicate increased catheter life, good hydraulic function, no inflow or outflow obstructions or pericatheter leaks, and minimal exit-site infections. PD has become an important aspect of dialysis management in developing countries. In the fourth article of this series, by Dr Prasad et al, an account of various accessrelated complications, both in acute and chronic PD, in developing countries, are described. Uniquely, most of these complications are related to the failure of TC. In patients with TC failure, there is a high risk of failure at subsequent use of TC. As can be appreciated, the peritoneal catheter is a life line for the PD patient, and the technology described here may prove to prolong the use of PD and reduce complications that have the potential risk of patients discontinuing PD.