The catheter problems regardless of placement technique are variable as 2 to 31% for flow dysfunction and catheter displacement (1,2) and 1 to 27% for pericatheter leak and hernia (3,4). The most common causes of catheter dysfunction are migration, fibrin clot and omental wrapping (5).Insertion of PDC under direct visualization by laparoscopy affords a number of advantages including decreased operating time, less perioperative pain and fewer complications compared to an open surgical approach (6,7). Various laparoscopic techniques have been described for catheter placement to reduce complications and improve results (7-9). These efforts include rectus sheath tunneling, omentectomy, selective prophylactic omentopexy, catheter fixation by suturing and selective resection of epiploic appendices and adhesiolysis.The aim of this study is to present a novel technique for laparoscopic placement of PDC through a preperitoneal tunnel which can reduce complications and improve catheter survival.
PaTIeNTs aND MeThoDsThis project was designed as a prospective interventional study, approved by the Research Committee and financially supported by the Research Deputy of Mashhad University of Medical Sciences. To reduce ambiguous results, we excluded patients who had a possibility of existing abdominal adhesion due to several abdominal operations, intestinal or urinary ostomy, or severe coagulopathies. With their informed consent, the patients were systematically examined. From