[Ms.RN]

Is inserting PD catheter considered a major surgery, or is it considered just a simple procedure? Why does it have to be done in OR, and cannot be done in ER?

[elcue]

Peritoneal dialysis placement is a pretty minor procedure, but requires sedation becuse the catheter needs to be tunneled from the skin down into the peritoneal space.

[janfrn]

Our surgeons place PD catheters right in the patient's bed in our unit. We crank up their drugs, muscle relax them and go for it. Of course, the ones who need Tenckhoffs in our unit are typically fresh post-op cardiac surgery patients who are intubated and ventilated, typically the Fontans.

[shodobe]

We place all in the OR because the one surgeon does it laparoscopically and we haven't done it the old fashion way in years. I have had too many surgeons place them blindly and they seem to never work in the end. Being able to see where it is going makes it better for the patient. We have also had to correct too many by surgeons from other facilities. I don't really consider any surgery where I patient is given a general a minor procedure, but that is just my opinion. Also, why would any patient in their right mind allow a CAPD to be put inserted in the ED?