Insertion of a Peritoneal Dialysis (PD) catheter under local anaesthetic

What is a Peritoneal Dialysis (PD) catheter?

A PD catheter is a soft silicone tube placed inside your abdomen which allows dialysis fluid to enter the abdominal cavity and then drain back out again.

Pre-assessment

You will be asked to attend an appointment with the Peritoneal Dialysis nurse. During this appointment your blood pressure, pulse and temperature will be recorded and other tests such as an ECG and pre procedure bloods will be taken.

A doctor or nurse will examine your abdomen to make sure you are suitable for the procedure. If you have had major abdominal surgery, you may not be suitable for medical insertion.

To reduce the risk of infection you will also be screened for Methicillin-Resistant Staphylococcus Aureus (commonly known as MRSA).

You will be given an antiseptic skin wash. This is to be used for the 5 days before the procedure, to reduce any bacteria on your skin.

You will also be given instructions and a prescription for a strong laxative to be used a few days before your surgery. This will clear your bowel and help to reduce the risk of bowel perforation and movement of the PD catheter when in place.

Personal belongings

Please do not bring valuables, such as jewellery or large sums of money into the hospital. If this is unavoidable, please ask a relative or a friend to take them home. The hospital cannot accept liability for the loss of items.

Before the procedure

You will be asked to come to the hospital on the day of the procedure, usually early morning.

A cannula (small sterile plastic tube) will be inserted in to a vein, usually in the back of the hand but can be on the inside of the elbow. This will allow medicines to be given straight in to a vein. We will also use this to give you antibiotics and pain relief before the procedure takes place.

During the procedure

The PD catheter will be inserted under local anaesthetic. This means that you will be awake for the procedure but will not be able to feel any pain, although you may feel some pressure during the procedure.

You will be given antibiotics, pain relief and anti-sickness medicine through the cannula in the back of your hand/arm.

The procedure will be carried out by a renal doctor or specialist nurse. If your procedure is planned for early morning, you will not be able to eat or drink after midnight the day before (known as nil by mouth). Please refer to your appointment letter for details.

After the PD catheter insertion, you will need to rest for a few hours before you can go home.

The fluid we use to flush through the catheter may be blood stained, this will clear without treatment.

Benefits of having the PD catheter inserted under local anaesthetic

You can go home the same day as the procedure. You will also have a smaller procedure wound.

Where will the PD catheter insertion be carried out?

You will have your operation in a special procedure room at Gloucestershire Royal Hospital. Please refer to your appointment letter for details.

How long will the procedure take?

The procedure will take about 1 hour but you should expect to be with us for 6 hours.

After the procedure

You will be able to go home a few hours after you have had the PD catheter inserted, as long as there are no complications and the staff are happy with your recovery.

You will be given information about after care and a follow-up outpatient appointment.

We advise you not to go home by public transport; this is for your comfort and safety. You can ask a relative or friend to drive you home but you should not drive yourself for at least 2 weeks after the procedure. You should also inform your insurance company of your procedure.

If you unable to arrange your own transport we will organise it for you. Please contact the Peritoneal Dialysis Specialist Nurses giving as much notice as possible. The contact details are at the end of this page.

Will I have any stitches?

You will be told which type of stitches were used to close the wound. These stitches will be removed by the Peritoneal Dialysis nurses at the follow up appointment.

Risks

There are very few risks associated with having a PD catheter inserted but you should be aware of the possible complications.

Puncture

When the PD catheter is being inserted, it may accidentally puncture the wall of your bowel or bladder. If this happens the catheter will be removed straight away. You may need to have an operation to repair your bowel. This is a very rare complication.

Poor position

After it has been inserted, your PD catheter may move into a poor drainage position especially if your bowels are not loose. It is important that you take the prescribed laxatives as directed after your procedure.

Infection

You will be told how to spot signs of an infection. If you do develop an infection you will need to take antibiotics. Rarely, you may need to have your PD catheter taken out if you develop an infection. Another PD catheter will be inserted a few weeks after the infection has cleared.

Cancellation of your appointment

Please contact the Peritoneal Dialysis Specialist Nurses

as soon as possible if you cannot attend your appointment, have diarrhoea and/or vomiting or have a fever. We can then advise you and offer another appointment.

Contact information

Renal Secretary

Tel: 0300 422 6762

Monday, Tuesday, Thursday and Friday 8:00am to 4:00pm

Ward 7b Renal Unit

Tel: 0300 422 6768

Access Specialist Nurses

Tel: 0300 422 6270

Monday to Friday, 8:00am to 4:00pm

Peritoneal Dialysis Specialist Nurses

Tel: 0300 422 6761

Monday to Friday, 8:00am to 4:00pm

Further information

Kidney Patient Guide

Website: www.kidneypatientguide.org.uk