Innovative management of peritoneal catheter malfunction caused by omental wrapping: exploration the modified low-temperature plasma ablation blade in vivo and in vitro

Abstract

Background Omental wrapping is a common complication of peritoneal dialysis, which manifests as catheter malfunction causing early termination of peritoneal dialysis. This study investigates the efficacy and safety of a Modified Low-Temperature Plasma Ablation (MLTPA) blade in treating omental-wrapped catheter malfunction.Method In vitro experiments using the MLTPA blade at the 5th power level were conducted to ablate omental tissues and catheters, evaluating ablation effects and potential catheter damage. In vivo, nine beagles were modeled for catheter malfunction due to omental wrapping, randomized into MLTPA blade (n = 5) and the Gastroscopic Biopsy Forceps (GBF) groups (n = 4). Dialysate outflow velocity, dialysate residual volume, and complications were recorded.Results In vitro experiments showed that the MLTPA blade effectively ablated omental tissue without damaging the catheter at the 5th power level. In vivo, the MLTPA blade group achieved a 100% (5/5) catheter recanalization success rate, significantly increasing catheter outflow velocity (111.4 ± 5.1 ml vs. 3.0 ± 1.0 ml, p < 0.0001), and reducing dialysate residual volume after ablation (81.0 ± 5.6 ml vs. 976.8 ± 4.6 ml, p < 0.0001). Treatment failures in the GBF group (4/4) were successfully resolved with MLTPA treatment. No significant differences in outflow velocity of dialysate were observed at 3 and 7 days post-canalization in the MLTPA blade group, without severe bleeding, infection, catheter migration, or organ damage.Conclusion The MLTPA blade rapidly ablates omentum within the lumen, recovering catheter function without severe complications. These findings provide preliminary evidence supporting the safety and feasibility of using the MLTPA blade to treat catheter malfunction caused by omental wrapping.

Keywords

• Peritoneal dialysis
• omental wrapping
• low-temperature plasma radiofrequency
• catheter malfunction