Peritoneoscopy in the management of catheter malfunction during CAPD. Dig Dis Sci

Continuous ambulatory peritoneal dialysis is widely used in the maintenance of patients with chronic renal failure. Obstruction or displacement of the chronic dialysis catheter, which prevents dialysate drainage, can compromise ongoing dialysis. Conservative approaches (body position change, saline infusion, and enema) are often unsuccessful and more aggressive therapy may be required. We report the use of peritoneoscopy to reposition malfunctioning peritoneal dialysis catheters. The procedure proved to be safe and gave excellent long-term results. Continuous ambulatory peritoneal dialysis (CAPD) has been widely used in the maintenance of patients with chronic renal failure since the description of the technique in 1976 (1, 2). Success of this treat-ment, however, is dependent upon good function of the peritoneal catheter. Some complications such as peritonitis, dialysate leakage, and exit site infection do not prevent continuing dialysis (2, 3). However, obstruction or displacement of the chronic catheter prevents dialysate drainage and limits ongoing CAPD (3, 4). Conservative approaches to drainage failure, which include body position change, saline infusion, and enemas, are often employed but are frequently unsuccessful (3). Often more aggressive therapy must be employed when conservative ap-proaches fail: trocar manipulation (4), surgical repo-sitioning (5), or replacement of the catheter (5). We report here an alternative approach. Peritoneos