Laparoscopic-Assisted Peritoneal Dialysis Catheter Placement, an Improvement on the Single Trocar Technique

Abstract

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.

New method of internal fixation in laparoscopic Tenckhoff catheter placement

“…“Advanced laparoscopic technique” refers to the use of adjunct techniques along with laparoscopy to reduce catheter dysfunction 10 . Two early retrospective studies showed that the laparoscopic technique was associated with a lower trend of complications and dysfunction than the open technique, but the difference was not statistically significant 11,12 . The application of these adjunct techniques provides the laparoscopic technique with clear advantages.…”

“…studies showed that the laparoscopic technique was associated with a lower trend of complications and dysfunction than the open technique, but the difference was not statistically significant. 11,12 The application of these adjunct techniques provides the laparoscopic technique with clear advantages. One randomized controlled trial demonstrated equal clinical success rates between the open and basic laparoscopic techniques.…”

Single-Port Laparoscopy for the Drainage of Abdominal Infected Fluid Collections in Children, With the TriPort System: Initial Experience of 2 Cases

“…[6][7][8][9] There have also been reports of application of a single trocar for direct placement of intraperitoneal drains in the past. Blessing et al 10 described their single-trocar technique for placement of a peritoneal dialysis catheter in 2005. Goitein et al 11 reported laparoscopically assisted ventriculoperitoneal shunt placement in 2006, avoiding the typical small midline laparotomy incision.…”