A new self-locating peritoneal catheter

.Objective: Peritoneal catheters often become dislocated, and this may lead to malfunction. Since it is not usually possible to bring them back into their correct position, they must be replaced. With the aim of preventing this complication, we designed a new catheter . .Design: The new catheter has the same form as the Tenckhoff catheter except for a small increase in external diameter of the last 2 cm, made possible by the high specific weight of a small12-g tungsten cylinder incorporated in the Silasticat the abdominal end. The new catheter may be inserted bya percutaneous technique. .Setting:University hospitals of Sienaand Perugia, Italy. .Patients: In the last three years, 32 of these catheters have been implanted for a total experience of 468 patientmonths. Thei r position was checked on insertion and every two months thereafter by radiography; 26 Tenckhoff catheters (415 patient-months) were studied at the same time. Insertion was performed surgically and bya percutaneous method. The frequency of cuff extrusion, exitsite infections, leakage, and peritoneal infection were noted, together with peritoneal function, which was evaluated by KTN and weekly creatinine clearance one month after catheter insertion; the tests were repeated when dislocation occurred and at the end of the trial. .Results: No dislocations occurred with the self-locating catheters, whereas nine dislocations occurred in control patients (p = 0.0003). There were no significant differences with respect to controls for cuff extrusion, exit-site infections, leakage, peritoneal infection, and peritoneal function. .Conclusions: The presence of a small weight at the catheter tip prevents displacement completely, keeping the intraperitoneal part of the catheter in place.