Double purse-string around the inner cuff of the peritoneal catheter: A novel technique for an immediate initiation of continuous peritoneal dialysis

Antonio Scalamogna, Luca Nardelli, Francesca Zanoni, Piergiorgio Messa

Research output: Contribution to journalArticlepeer-review


International guidelines recommended a delayed start of peritoneal dialysis at least 2 weeks between catheter insertion and continuous peritoneal dialysis therapy initiation (break-in period). Up to now, the optimal duration of the break-in period is still unclear. The aim of our study was to evaluate in patients, with immediate initiation of continuous peritoneal dialysis, the efficacy of a double purse-string around the inner cuff in preventing mechanical and infectious complications either in semi-surgical or surgical catheter implantation. From January 2011 to December 2018, 135 peritoneal dialysis catheter insertions in 125 patients (90 men and 35 women, mean age 62.02 ± 16.7) were performed. Seventy-seven straight double-cuffed Tenckhoff catheters were implanted semi-surgically on midline under the umbilicus by a trocar, and 58 were surgically implanted through the rectus muscle. In all patients, continuous peritoneal dialysis was started immediately after catheter placement. Mechanical and infectious catheter-related complications during the first 3 months after initiation of continuous peritoneal dialysis were recorded. The overall incidence of leakages, catheter dislocations, peritonitis, and exit-site infections was 4/135 (2.96%), 2/135 (1.48%), 14/135 (10.3%), and 4/135 (2.96%), respectively. Regarding the incidence of catheter-related complications, no bleeding events, bowel perforations, or hernia formations were observed with either the semi-surgical or surgical technique. Double purse-string technique around the inner cuff allows an immediate start of continuous peritoneal dialysis both with semi-surgical and surgical catheter implantation. This technique is a safe and feasible approach in patients needing an urgent peritoneal dialysis.

Original languageEnglish
Pages (from-to)365-371
JournalInternational Journal of Artificial Organs
Issue number6
Publication statusPublished - 2020


  • break-in period
  • catheter dislocation
  • catheter insertion
  • catheter survival
  • double purse-string
  • end-stage renal disease
  • exit-site infection
  • leakage
  • Peritoneal dialysis
  • peritoneal dialysis complications
  • peritonitis
  • Tenckhoff
  • trocar

ASJC Scopus subject areas

  • Bioengineering
  • Medicine (miscellaneous)
  • Biomaterials
  • Biomedical Engineering


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