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It appears possible to envisage, and especially in patients where the vascular and in particular, venous system is defective, the insertion of a Sparks obturator as soon as the indication for haemodialysis is considered and before is indispensable. In the case of urgent haemodialysis, in most instances the nephrologist himself inserts a Scribner shunt in order to be able to dialyse his patient as rapidly as possible. There is no contraindication to the insertion, either at the same time or during the next few days, of an obturator which may be anastomosed to the vessels much later. All arterio-venous fistulae, all systems which may alter, should, in our opinion, be equipped in this way, so that as soon as maturation of the obturator has occurred immediate availability of an excellent means of access exists.

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It appears possible to envisage, and especially in patients where the vascular and in particular, venous system is defective, the insertion of a Sparks obturator as soon as the indication for haemodialysis is considered and before is indispensable. In the case of urgent haemodialysis, in most instances the nephrologist himself inserts a Scribner shunt in order to be able to dialyse his patient as rapidly as possible. There is no contraindication to the insertion, either at the same time or during the next few days, of an obturator which may be anastomosed to the vessels much later.

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