Clinical application of one-port laparoscopic placement of peritoneal dialysis catheters

Abstract

Laparoscopic techniques for placement of peritoneal dialysis catheters are becoming increasingly popular. This study describes an one-port laparoscopic technique for insertion of peritoneal dialysis catheters. Eighteen consecutive chronic renal failure patients underwent laparoscopic placement of Swan-neck catheters. All patients were eligible to receive local infiltration anaesthesia and none had had a previous peritoneal catheter placed. Videoscopic monitoring was performed via a peel-away sheath through an incision near the umbilicus; a 16 Fr peel-away sheath was then inserted towards the bladder and rectum. A Swan-neck catheter was passed through the peel-away sheath into the true pelvis. A subcutaneous tunnel was created and a point in left lower quadrant was selected as the exit site of the catheter. All the catheters were successfully placed and the mean time of operation was 26.5 min (range 14-35 min). The patients were discharged 2-4 days following the operation. During a mean follow-up period of 10.6 months (range 6-18 months), there were no catheter-related complications, such as catheter migration, dialysate leakage, exit-site infection and bacterial peritonitis. One-port laparoscopic technique is a simple, safe and effective method for placement of peritoneal dialysis catheters.