Outpatient management of malignant ascites using ultrasound, a trocar, and a Tenckhoff catheter.

The Tenckhoff catheter provides useful access to the peritoneal cavity for chronic peritoneal dialysis and treatment of intraperitoneal malignancy. The usual methods of placement of Tenckhoff catheters include: blind insertion, open surgical implantation and peritoneoscopic guided placement. This is a description of a technique for percutaneous introduction using a trocar. Sonographic guidance is used to assure a safe insertion and proper location. This technique has been used in the office to provide access to the peritoneal cavity to allow palliative management of massive, intractable malignant ascites. The patient or selected caretaker can care for and access the catheter intermittently at home for relief of symptoms.