Table 3.

Challenges to surgeon availability for access placement

Challenges
Limited expertise related to inadequate exposure and training (11)
Limited operating room time
Conflicting responsibilities
 Administrative
 Renal transplant or other surgical proceduresa
 Vascular access placement
Recurrent catheter troubleshooting after initial PD catheter placement
Coverage issues secondary to small surgical team (11)
Reimbursement not lucrative for the time invested in PD catheter placement (12)
Low volume of procedures, and hence inability to make it a niche
  • PD, peritoneal dialysis.

  • a At University of Alabama at Birmingham, PD catheters are placed by renal transplant surgeons.