The Vicenza “Short” Peritoneal Catheter: A Twenty Year Experience

Abstract

Dislocation of peritoneal dialysis catheters is one of the major causes of technique failure. We evaluated 701 Vicenza catheters, implanted since 1985 in 365 males, mean age 53 ± 16 yrs, range 24 - 87, and 336 females, mean age 51 ± 17 yrs, range 21 - 82. The Vicenza catheter is defined “short” since it consists of a classic straight double cuff PD catheter having however an inner segment (the portion located in the peritoneal cavity) much shorter than any other type of catheter. It is implanted in the lower abdomen, just a few centimeters above the pubis. The analysis of our results obtained in a large PD population displayed good device survival at 2 and 5 years (94.3% and 91.5% respectively), a low dislocation rate (4%) and an exit-site infection rate similar to other double cuffed catheters. There was no selection of patients receiving this catheter since from 1985 we have used this catheter in every incident patient. Due to its lower implantation site this catheter demonstrates excellent wearability and good body image acceptance.

A Modified Open Surgery Technique for Peritoneal Dialysis Catheter Placement Decreases Catheter Malfunction

“…Table 3 shows representative studies of double-cuffed straight catheter placement. The rate of catheter malfunction in the modified open surgery group in our study is comparable to rates reported in earlier studies (19,(28)(29)(30)(31)(32)(33).…”

“…As a proof of concept, the present study has shown (as have others) a promising decrease in catheter malfunction with modification of the open surgery procedure (19,29,30,33). Although the use of a low incision site has previously been reported, the introduction in this study of an individualized length of catheter, coupled with a long, straight, upward tunnel, may bring more potential benefits to catheter placement, as has already been discussed.…”

“…Although the use of a low incision site has previously been reported, the introduction in this study of an individualized length of catheter, coupled with a long, straight, upward tunnel, may bring more potential benefits to catheter placement, as has already been discussed. Moreover, the long, straight, upward tunnel effectively avoids an extremely low exit site, commonly seen in other low-incision techniques, which may be inconvenient for incision care (29,33). An over-sharp angle between the two limbs of the straight catheter may increase the torque and should be avoided in the traditional technique.…”

Peritoneal catheter fixation combined with straight upward tunnel and low implant position to prevent catheter malfunction

“…Up to now, open surgery is still the most commonly used PD catheter insertion technique. Previous studies showed that a short, mobilizable intra‐abdominal catheter was useful in reducing catheter malfunction . However, the implant position of traditional open surgery is 11 cm above the pubic symphysis with a long length of intra‐abdominal catheter segment, which might lead to a high incidence of catheter tip migration and omentum wrap.…”

“…Previous studies showed that a short, mobilizable intra-abdominal catheter was useful in reducing catheter malfunction. 12,13 However, the implant position of traditional open surgery is 11 cm above the pubic symphysis with a long length of intra-abdominal catheter segment, which might lead to a high incidence of catheter tip migration and omentum wrap. It is reported that 7.6-17.1% of patients developed catheter tip migration when using this open technique.…”