Some patients with end-stage renal disease are candidates for peritoneal dialysis, which uses the peritoneum as a filter to help remove toxins from the blood that can no longer be cleared by the poorly functioning kidneys. (The peritoneum is a thin membrane that lines the abdominal cavity and all the organs in the abdomen.) A catheter is placed in the abdominal cavity, permitting dialysis fluid to be instilled into, and then removed from, the abdomen.
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Peritoneal dialysis catheters are placed under laparoscopic guidance by a surgeon. Laparoscopy, in which a camera is placed into the abdomen, allows the surgeon to view the structures in the abdomen to precisely place the catheter into the pelvis, and to free up any scar tissue that may have formed from any prior surgery or infection in the abdomen.
A peritoneal dialysis catheter offers the patient increased freedom and minimizes lifestyle interruptions. Once the catheter is surgically implanted, dialysis can be performed at home by the patient based on his/her individual schedule and needs. Dialysis can be performed either at night, with the aid of a machine called a “cycler,” or during the day, via manual exchanges. The cycler is portable and can even travel on an airplane. Additionally, supplies can easily be shipped to an alternate destination to allow patients to continue their dialysis while away from home. This process allows for much greater autonomy for patients than traditional hemodialysis. Patients will be teamed with peritoneal dialysis nurses who will train them on proper care and handling of the catheter, and will help maintain their peritoneal dialysis supplies.
The operation typically takes about one hour and is performed on an outpatient basis. Patients will require general anesthesia for the procedure. Patients can begin to use their new dialysis catheter as soon as the next day if needed. Before and after the surgery, there are some important instructions patients should follow to allow the catheter to continue to function properly. One of the most important is the use of stool softeners, which should be started 3 days leading up to the surgery and at least 3 days following the surgery. Patients should also make sure they do not have anything to eat or drink after midnight on the night before their operation. If patients take medications in the morning, they may do so with a small sip of water. See below for more specific guidance on these topics and recommended dosages of stool softeners.
After Your Surgery: Peritoneal Dialysis Catheter Discharge Instructions
Common Questions Regarding Peritoneal Dialysis Catheter Surgery