Lateral catheter insertion together with three purse-string sutures reduces the risk for leakage during peritoneal dialysis.

Insertion of a catheter is needed to perform peritoneal dialysis. Techniques for insertion vary and have different drawbacks with regard to risk for leakage, secondary peritonitis, and catheter dysfunction. This study includes 85 consecutive patients who underwent a total of 114 insertions; peritoneal dialysis catheters (Tenckhoff, double-cuffed) were inserted under local anesthesia and using a lateral technique--through the rectus muscle--plus 3 purse-string sutures. Dialysis in all patients was started in the direct course of insertion of the catheter. One early but no late leakage occurred; leakage occurred in a patient in whom the second purse-string suture failed. The lateral insertion technique enables immediate start of dialysis and considerably reduces the risk for leakage from peritoneal dialysis fluid.