PERITONEAL ACCESS DEVICES

At first, both hard and soft catheters were used to obtain access to t he peritoneal cavity. In 1959, Dr Maxwell standardized the use of a ri gid nylon catheter and this became the catheter of choice. A modificat ion by Weston and Roberts simplified the insertion of the catheter. Un fortunately, the rigid catheter could not be used for chronic renal fa ilure patients because it moved to and fro in the sinus tract, resulti ng in infection of the exit site. Many attempts were made to solve thi s problem by using a conduit through which the catheter could be passe d but these failed due to infection. Meanwhile, the development of a r elatively biocompatible plastic, silicone rubber, provided a new oppor tunity for soft catheters. Progress with these catheters lead to the T enckhoff catheter, which together with a standardized procedure for in sertion and care, resulted in its acceptance as the primary type of ca theter used today. Peritonitis and exit site infections are less commo n but there is still a need for a catheter which is user friendly.