Peritoneal Dialysis University for Surgeons: A Peritoneal Access Training Program

Crabtree, John H.; Penner, Todd; Armstrong, Sean; Burkart, John M.

doi:10.3747/pdi.2015.00013

Cited by 11 publications

(7 citation statements)

References 14 publications

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“…M ost peritoneal dialysis (PD) catheters are removed within a few years of placement (1). The standard technique for removal of PD catheters is by surgical dissection of the silicon tube and the attached Dacron cuff (2–5). This procedure is usually per formed in the operating room under intravenous sedation or general anesthesia, and involves a dissection deep into the abdominal wall.…”

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confidence: 99%

The ‘Pull’ Technique for Removal of Peritoneal Dialysis Catheters: A Call for Re-Evaluation of Practice Standards

et al. 2017

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♦ BACKGROUND: The most commonly used peritoneal dialysis (PD) catheters have silicon tubing with attached Dacron cuffs. The current standard of care for PD catheter removal is by complete surgical dissection, withdrawing both the tubing and the cuffs. The intention is to avoid infection of any residual part of the catheter. We retrospectively analyzed our results with the alternative 'pull' technique, by which the silicon tube is pulled out, leaving the Dacron cuffs within the abdominal wall. This technique never gained popularity due to concern that the retained cuffs would get infected. ♦ METHODS: We reviewed our experience from an 18-month period, between January 2014 and June 2015. There were 46 catheter removals in 40 patients. All the catheters were of the double-cuffed coiled Tenckhoff type (Covidien, Dublin, Ireland). ♦ RESULTS: Of the 46 catheter removals by the 'pull' technique, there was only 1 case of retained cuff infection. ♦ CONCLUSIONS: The 'pull' technique is a safe method for Tenckhoff catheter removal with low risk of infection. We strongly recommend it as the procedure of choice.

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confidence: 99%

The ‘Pull’ Technique for Removal of Peritoneal Dialysis Catheters: A Call for Re-Evaluation of Practice Standards

et al. 2017

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“…30 More than 1000 doctors have participated in the past, and training has been carried out under the surgical guidance of skilled instructors. Two training programmes are similar to the ‘PD University for Surgeons’ organised by Crabtree et al, 31 except that they deal with laparotomy rather than laparoscopic surgery. The laparoscopic surgery for PD catheter placement is not covered by health insurance in Japan.…”

Section: Discussionmentioning

confidence: 99%

A multi-institutional, observational study of outcomes after catheter placement for peritoneal dialysis in Japan

Sakurada,

Kojima,

Yamada

et al. 2023

Perit Dial Int

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Background: This multi-institutional, observational study examined whether the outcomes after peritoneal dialysis (PD) catheter placement in Japan meet the audit criteria of the International Society for Peritoneal Dialysis (ISPD) guideline and identified factors affecting technique survival and perioperative complications. Methods: Adult patients who underwent first PD catheter placement for end-stage kidney disease between April 2019 and March 2021 were followed until PD withdrawal, kidney transplantation, transfer to other facilities, death, 1 year after PD start or March 2022, whichever came first. Primary outcomes were time to catheter patency failure and technique failure, and perioperative infectious complications within 30 days of catheter placement. Secondary outcomes were perioperative complications. Appropriate statistical analyses were performed to identify factors associated with the outcomes of interest. Results: Of the total 409 patients, 8 who underwent the embedded catheter technique did not have externalised catheters. Of the 401 remaining patients, catheter patency failure occurred in 25 (6.2%). Technical failure at 12 months after PD catheter placement calculated from cumulative incidence function was 15.3%. On Cox proportional hazards model analysis, serum albumin (hazard ratio (HR) 0.44; 95% confidence interval (CI) 0.27–0.70) and straight type catheter (HR 2.14; 95% CI 1.24–3.69) were the independent risk factors for technique failure. On logistic regression analysis, diabetes mellitus was the only independent risk factor for perioperative infectious complications (odds ratio 2.70, 95% CI 1.30–5.58). The occurrence rate of perioperative complications generally met the audit criteria of the ISPD guidelines. Conclusion: PD catheter placement in Japan was proven to be safe and appropriate.

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“…Hands-on courses have become a key component to procedural learning and adoption for physicians across multiple specialties and at all levels of training [ 10 – 13 ]. However, hands-on courses alone have not always led to successful procedural adoption for surgeons in practice.…”

Section: Discussionmentioning

confidence: 99%

At-home hands-on surgical training during COVID19: proof of concept using a virtual telementoring platform

et al. 2021

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Introduction Surgeons in practice have limited opportunities to learn new techniques and procedures. Traditionally, in-person hands-on courses have been the most common means for surgeons to gain exposure to new techniques and procedures. The COVID19 pandemic caused a cessation in these courses and left surgeons with limited opportunities to continue their professional development. Thus, SAGES elected to create an innovative hands-on course that could be completed at home in order to provide surgeons with opportunities to learn new procedures during the pandemic. Methods This course was initially planned to be taught as an in-person hands-on course utilizing the Acquisition of Data for Outcomes and Procedure Transfer(ADOPT) method 1 . We identified a virtual telementoring platform, Proximie Ltd(London, UK), and a company that could create a model of an abdominal wall in order to perform a Transversus Abdominis Release, KindHeart™(Chapel Hill, NC, USA). The course consisted of pre-course lectures and videos to be reviewed by participants, a pre-course call to set learning goals, the hands-on telementoring session from home, and monthly webinars for a year. Results The ADOPT hands-on hernia course at home was successfully completed on October 23rd of 2020. All participants and faculty were successfully able to set up their model and utilize the telementoring platform, but 15% required assistance. Post course-surveys showed that participants felt that the course was successful in meeting their educational goals and felt similar to prior in-person courses. Conclusions SAGES was successfully able to transition and in-person hands-on course to a virtual at-home format. This innovative approach to continuing professional development will be necessary during the times of the COVID19 pandemic, but may be a helpful option for rural surgeons and others with travel restrictions in the future to continue their professional development without the need to travel away from their practice.

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Peritoneal Dialysis University for Surgeons: A Peritoneal Access Training Program

Abstract: A comprehensive 1-day peritoneal access training course can produce long-term self-assessed improvement in surgical management and PD catheter outcomes.

Cited by 11 publications

References 14 publications

The ‘Pull’ Technique for Removal of Peritoneal Dialysis Catheters: A Call for Re-Evaluation of Practice Standards

The ‘Pull’ Technique for Removal of Peritoneal Dialysis Catheters: A Call for Re-Evaluation of Practice Standards

A multi-institutional, observational study of outcomes after catheter placement for peritoneal dialysis in Japan

At-home hands-on surgical training during COVID19: proof of concept using a virtual telementoring platform

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