In 2002, Ochsner laparoscopic surgeons and nephrologists began placing peritoneal dialysis (PD) catheters via a laparoscopic-assisted method. We compared laparoscopically placed PD catheters (LAPD) with catheters most recently placed without laparoscopic aid (STPD). The method for this study is a retrospective chart review. Demographics of both groups were similar. Nine of 20 (45%) in the STPD group and 16 of 23 (70%) in the LAPD group had had previous abdominal surgery. Three of 20 (15%) of STPD had complications, including one small bowel injury. Four of 23 (17.4%) of the LAPD had complications. One of 20 (5%) in the STPD group and 3 of 23 (13%) in the LAPD group had dialysate leaks. In the STPD group, 8 of 20 (40%) had catheter problems that led to removal in 7 (35%). In the LAPD group, 6 of 23 (26%) had catheter malfunction: 3 were salvaged with a laparoscopic procedure; 3 (13%) were removed for malfunction. 1) LAPD allows proper PD placement after complex abdominal surgery; 2) Although dialysate leak complications are increased, bowel perforation risk is less; 3) Because of proper placement, PD catheter malfunction rate is less with LAPD; 4) Although no results obtained statistical significance, we found LAPD superior to STPD and have converted to this technique.
* BACKGROUND AND OBJECTIVE: The optimal placement and laser energy levels of a new contact probe with a variable focus used for transscleral diode cyclophotocoagulation were compared with the diode laser noncontact technique.
* MATERIALS AND METHODS: Fresh cadaver eyes were evaluated by a modified posterior Miyake view using videotape, light microscopy, and scanning electron microscopy.
* RESULTS: The noncontact diode technique at maximum energy (1.2 J) and contact diode applications at similar energy levels failed to produce obvious gross tissue ciliary body change and mild alterations by histology. Consistent gross, histologic, and scanning electron microscopic damage was noted at 3.0 J or more with the contact probe placed at the surgical limbus and defocused 0.5 to 1.5 mm posteriorly.
* CONCLUSIONS: This study indicates that the Multilase contact diode laser causes transscleral ciliary body destruction in a cadaver eye model and may have potential clinical usefulness.
[Ophthalmic Surg Lasers 1996;27:60-65.]
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