A new laparoscopic technique for the placement of a permanent peritoneal dialysis catheter: the preperitoneal tunneling method

Abstract

The advantages of this method include accurate placement, preperitoneal fixation, and immediate use of the catheter for routine peritoneal dialysis. We also believe that because of the preperitoneal fixation of the catheter, this technique will decrease outflow obstruction, which usually occurs due to omental wrapping or displacement of the catheter tip.

Advanced Laparoscopic Peritoneal Dialysis Catheter Insertion: Systematic Review and Meta-Analysis

“…Several studies have examined the synergistic effect of combining RST, selective omentopexy, and adhesiolysis in terms of catheter dysfunction and catheter survival rates with (3,(15)(16)(17)(18)(19)(20) or without (21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34) comparison with open and basic laparoscopic insertion techniques. Crabtree et al published the largest case series, which examined 428 patients who had a PDC placed using RST along with selective omentopexy and adhesiolysis.…”

Preperitoneal Tunneling – a Novel Technique in Peritoneal Dialysis Catheter Insertion

“…Direct vision into the peritoneum and performing interventions like repairing hernia, omentectomy, and adhesionolysis are also mentioned as the other advantages of this technique (11,12).…”

“…The most similar technique to our method is Comert et al (11), except for passing the catheter through the rectus muscle in their method. The length of the tunnel is similar to our method but they advanced the catheter toward the symphysis pubis, which we believe increases the possibility of catheter kinking.…”

SAGES guidelines for laparoscopic peritoneal dialysis access surgery

“…Tunneling of the catheter in a craniocaudal direction through the rectus sheath toward the pelvis has been variously described as ''rectus sheath tunneling,'' ''musculofascial tunneling,'' ''extraperitoneal tunneling,'' and ''preperitoneal tunneling'' [2][3][4][5]. Importantly, the SAGES Guidelines standardize the terminology by promoting a word description that correctly reflects the anatomic pathway of the tunneling process, therefore, rectus sheath tunneling.…”