Premium
Mini‐laparoscopic placement of peritoneal dialysis catheter: New technique
Author(s) -
Seleem Mohamed I.,
AlHashemy Ahmed M.
Publication year - 2007
Publication title -
surgical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.109
H-Index - 10
eISSN - 1744-1633
pISSN - 1744-1625
DOI - 10.1111/j.1744-1633.2007.00333.x
Subject(s) - medicine , catheter , peritoneal dialysis , surgery , laparoscopy , port (circuit theory) , dialysis , anesthesia , engineering , electrical engineering
Background: Leakage remains a problem with all methods of catheter placement. We describe our experience with a new mini‐laparoscopic technique for catheter placement in patients with end‐stage renal failure. Patients and methods: Between May 2002 and March 2004 , 24 patients underwent mini‐laparoscopic placement of peritoneal dialysis catheters. All patients had end‐stage renal failure with difficult vascular access for haemodialysis. There were 11 men and 13 women with a mean age of 51.4 years (range: 18–75 years). Operative time, interval to initiation of successful peritoneal dialysis, postoperative pain management, resumption of diet and postoperative complications were recorded. Results: The mean operative time was 32.3 min (range: 15–40 min). All patients were given a normal diet on the day of surgery. Postoperative pain was controlled with paracetamol tablets three times daily for 2–3 days. The mean hospital stay was 3.2 days (range: 3–4 days). No patients developed leakage either from the ports or around the catheter. Two (8.3%) patients had blockage of the catheter and underwent diagnostic laparoscopy and laparoscopic correction. Two (8.3%) patients had migration of the catheter which required laparoscopic repositioning. The follow‐up range was between 2 and 22 months. Conclusion: Mini‐laparoscopic technique for placement of peritoneal dialysis catheter is unique because it uses only two ports. The catheter is made to exit via a 2 mm port site and does not require specially designed instruments.