A patient with end-stage renal disease presented for removal of his peritoneal dialysis catheter, because of concern for peritonitis. During the removal procedure, the previous periumbilical scar was incised down to the fascia. The catheter was followed through the fascia and the peritoneal cuff was identified and dissected free. When the intraperitoneal portion of the catheter was removed, there was direct visualization of the undersurface of the fascia, as well as omentum and small bowel. The catheter was cut and the intraperitoneal portion of the catheter was passed off the table. The subcutaneous portion of the catheter was then easily removed. What is the appropriate approach value for removal of the peritoneal dialysis catheter?
The catheter was removed under direct visualization. Assign the approach value, “0” Open for the catheter removal. In this case, an incision was made through the scar and down to the fascia. The peritoneal cuff was visualized and dissected free.