Laparoscopy-assisted peritoneal dialysis catheter placement using a modified minimally invasive approach: A retrospective observational study

Abstract

Peritoneal dialysis is a reliable and effective treatment for end-stage kidney disease. However, inadequate catheter insertion can lead to mechanical dysfunction, which remains an unresolved problem. In this study, we present the initial results of a modified laparoscopic approach. This study included 38 patients who underwent peritoneal dialysis using a modified laparoscopic approach. During the procedure, a single laparoscopic trocar was employed, and peritoneal entry was performed using a percutaneous pull-apart sheath/dilator. To minimize the risk of complications, the free catheter portion was kept short in the peritoneum. The modified method was guided by proven recommendations of the standard laparoscopic technique. The mean operation time was recorded as 24.28 ± 15.5. The mean hospitalization was found to be 1.20 ± 0.72 days. The postoperative morbidity was 26.3%. The mechanical dysfunction rate was 5.26%. The median follow-up time was 20.4 ± 17.14 months. The median peritoneal dialysis catheter-free survival was 25.96 ± 4.02 months. The catheter-free survival rate was 92.11%. The modified laparoscopic approach has been demonstrated to be a safe and effective option, and initial studies have indicated that it offers several benefits over traditional methods, including a straightforward procedure with a brief duration, minimal complications, and brief hospital stay.