Laparoscopic Tenckhoff catheter insertion: a retrospective study over 6 years

Abstract

Peritoneal dialysis via Tenckhoff catheter predisposes to hernia formation due to both local and systemic factors. Another important complication of peritoneal catheter insertion includes infection, which can prompt removal of the catheter. We performed a retrospective study between January 2005 and July 2011 of 61 patients who underwent laparoscopic placement of a Tenckhoff catheter and peritoneal dialysis at our institution using a single-port technique. We analysed complications of Tenckhoff insertion, specifically infection and the formation of hernias requiring operative management. Infections noted in our patients included peritonitis (10%) and exit-site infection (5%). Of the five patients who required re-insertion of Tenckhoff catheter, four were for infective complications. A total of seven hernias developed in five (8%) of patients, mostly inguinal or umbilical near the Hassan port entry site. With infection and hernia formation being the main contributors to failure of the procedure, actively addressing the entry site and areas predisposed to hernia formation, observing aseptic technique and meticulous attention to early signs of complications during follow-up are vital to improve success rates. The outcomes of the laparoscopic single-port insertion technique shows promise compared with conventional Tenckhoff catheter insertion techniques.