What does the PD insertion procedure involve?
What does the PD insertion procedure involve?A PD insertion can be done under general or local anaesthetic. This will depend on the Unit where the person is treated. The procedure will be along the following lines:
Just before their operation the person will be asked to empty their bladder of any urine, and put on a gown. They will be asked to remove any nail polish, jewellery or dentures. They will be taken to theatre by one of the nursing staff and a porter and helped onto a trolley. The anaesthetist will put some liquid down the plastic tube that they had put in the back of their hand (previously used to give antibiotics), and this will put them to sleep. They will be given further drugs, which will ensure they don’t wake up again until the operation is finished. The surgeon will make a cut about 8-10cms (4 inches) long down (occasionally across) the tummy. After dividing the tummy muscle, using special equipment the catheter is put in place and the part of the catheter that stays outside the skin is brought out through a small hole further down the tummy (therefore known as the ‘exit site’). The operation site will be closed with stitches or staples.
The doctor doing the operation and the PD nurse assisting will be wearing gloves, gowns and masks. They will explain to the person what they are about to do, and be able to reassure them during each stage of the procedure. The person will be asked to lie on a couch and their tummy will be cleaned and shaved, and the area will be numbed using local anaesthetic given with a small needle. This usually stings. A 2-3cm cut is made below the belly button. The person will be asked to lift their head up and tense their tummy muscles. A needle and special wire are inserted into the tummy, and the PD tube is passed into the peritoneal cavity. The person is asked to say when they feel any pain and where it is being felt. The procedure takes around 10 to 15 minutes.
The person or their carer will be taught how to care for the site where the catheter comes out of the skin (known as the exit site) according to the Unit's policy. Usually the dressing that is on when the person returns from theatre is left on for several days unless it is blood stained. Most Units teach people to wash their hands, remove the old dressing and put a new dressing in its place. The site is not handled or cleaned, and any dried crusts of blood are left to come off with the dressing. People are advised to avoid getting the exit site wet until it is healed, and are told how to tell if their exit site is infected.
NKF Controlled Document No. 240, What does the PD insertion procedure involve?, written 26 January 2001. Last reviewed 28 January 2010.
The National Kidney Federation cannot accept responsibility for information provided. The above is for guidance only. Patients are advised to seek further information from their own doctor.
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Page created: 26 January 2001
Last updated: 29 April 2009