Peritoneal Dialysis Catheter Insertion

What is a PD catheter?

Peritoneal dialysis (PD) cleans the blood using the lining of your own abdomen, with fluid cycled in and out through a soft silicone catheter — often overnight, at home. The whole therapy depends on that one catheter sitting in the right place and flowing freely, which makes the insertion the step worth getting right.

Laparoscopic or open insertion

I place PD catheters either laparoscopically or by open technique. The laparoscopic approach — keyhole surgery under general anaesthesia — allows the catheter tip to be positioned in the pelvis under direct vision, lets me deal with adhesions from previous surgery at the same sitting, and permits fixation techniques that reduce the chance of the catheter migrating or being wrapped by fatty tissue. Open insertion under local or regional anaesthesia is a sound alternative for patients better served by avoiding general anaesthesia. Which approach fits depends on your surgical history, anaesthetic fitness and your renal team's timeline.

What the procedure involves

• Usually a day procedure or a single-night stay
• The catheter is tunnelled under the skin so the exit site sits away from the belt line, positioned with daily life and hygiene in mind
• A break-in period of around two weeks typically follows before full-volume PD starts, while the exit site heals — your renal unit guides the exact timing

What to expect afterwards

Mild wound discomfort settles within days. The exit site needs the routine care your PD nurses will teach; done well, most catheters run for years. Early leak of fluid, catheter migration or slow drainage, exit-site infection and hernia at the insertion site are uncommon but recognised issues — most have straightforward fixes, some of them laparoscopic.

Is it right for me?

If PD is your planned therapy, the catheter should go in with enough lead time to heal before it is needed. At consultation I go through your history and the approach that fits, coordinating timing with your renal physician — part of the same one-stop access practice that looks after fistulas and grafts.