It is possible to have long term haemodialysis using a ‘tunneled catheter’. The catheter enters a central vein in one point, goes through a ‘tunnel’ beneath the skin and leave at the end of the tunnel. There was a ‘cuff’ to enable good fixation to the body. The chance of infection is much reduced.There are various brand of such long term catheters, the’PermCath’, ‘Split stream’ and the ‘RetrO catheter’. Dr Ho Chung Ping demonstrated how to implant a RetrO catheter using ultrasound and X-ray guidance.