Modified minimally invasive laparoscopic peritoneal dialysis catheter insertion with internal fixation

Abstract

Background Laparoscopic technique is widely used in peritoneal dialysis (PD) catheter placement. We developed a modified minimally invasive laparoscopic PD catheter (PDC) insertion with internal fixation and evaluated the early results by observing the intraoperative and postoperative conditions of the novel technique with those of conventional open surgery. Methods Retrospective research was performed on 59 patients who underwent PDC insertion from June 2019 to January 2022, including 23 patients who received open surgery and 36 patients who received modified minimally invasive laparoscopic surgery. Information such as preoperative conditions, operation time, incision length, incidence of intraoperative complications, time from operation to starting PD, time from operation to discharge, and incidence of catheter-related complications were collected and analyzed. Results The incision length, intraoperative blood loss, catheter migration rates and the total incidence of complications 6 months after operation in the laparoscopic group were lower than those in the conventional group. There were no statistically significant differences between the two groups in operation time, time from operation to starting PD, time from operation to discharge and the incidence of catheter blockage, leakage, exit-site infection, peritoneal dialysis associated peritonitis and hernia. Conclusions Modified minimally invasive laparoscopic PDC insertion and internal fixation method achieved direct vision and reliable fixation of the catheter, significantly reduced incision length and blood loss. The incidence of catheter migration was significantly lower than that of open surgery. Our primary findings reveal that modified minimally invasive laparoscopic PDC insertion with internal fixation is safe, effective and beneficial for PD patients.

Laparoscopic Placement Of Peritoneal Dialysis Catheter – A Decade Of A Tertiary Single Center Experience

“…Continuous variables are presented as median and quartiles [1,3]. Microsoft Excel 2013 was used for graphics and tables.…”

“…The placing of the PD catheter is performed by nephrologists, interventional radiologists or general surgeons. [3] The long-term success of PD begins with the correct choice of catheter type and the correctness of its placement.…”

The Peritoneal Tie Technique: Our Laparoscopic Catheter Placement for Peritoneal Dialysis

“…Patients are discharged safely on the rst postoperative day. (1)(2)(3)(4)(5)(6)(7) The nephrologist is responsible for catheter management and break-in to peritoneal dialysis.…”

“…The PD catheter exit site on the skin is placed about 2-4 cm laterally from the subcutaneous cuff. (1)(2)(3)(4)(5)(6)(7) Correct in ow and out ow will be tested with at least 500 ml of saline with the patient in the neutral position.…”

Suture passer combined with two-hole laparoscopic peritoneal dialysis catheterization in patients undergoing peritoneal dialysis

“…The primary methods for PDC insertion include bedside insertion or percutaneous implantation, surgical insertion, peritoneoscopic insertion, and laparoscopic insertion [ 6 ]. Compared to open surgery, laparoscopic surgery has been reported to cause fewer incidences of catheter malfunction, have shorter operative time, and lower short-term complication rates [ 7 , 8 ]. Laparoscopic technology has replaced open technology and is now the most widely used PDC placement method in the United States [ 9 ], favored for its visual operation advantages.…”