Value of peritoneoscopy for nonfunctioning continuous ambulatory peritoneal dialysis catheters.

We examined our results in restoring continuous ambulatory peritoneal dialysis (CAPD) catheter function via peritoneoscopy in 10 procedures performed on nine patients. Malfunction was caused by the catheter being encased in adhesions, being buried in small bowel, or being wrapped and occluded in omentum. In five of these cases we were successful in restoring catheter patency, thereby allowing immediate reinstitution of dialysis. Neither previous abdominal surgeries nor the length of time the catheter had been in place prior to malfunction appeared to be predictive for the cause of malfunction or the success of peritoneoscopic manipulation. We found outpatient peritoneoscopy to be safe and cost effective. We recommend it as the initial procedure to restore patency to malfunctioning CAPD catheters after conservative therapy has failed.