Modified laparoscopic(LAP) Peritoneal Catheter(PDC) insertion has the best reported procedural success rates due to peritoneal visualization and concomitant procedures of: adhesionolysis(AHX), omentectomy(OMT), hernia repair(HR) and catheter fixation(CF). However, little is reported of its role in salvage of previously inserted malfunctioning PDC. We describe the role of laparoscopy in PDC salvage by a single surgeon(KH) in our center. Retrospective analysis of PDC database and electronic medical records from LAP PDC salvage program inception (July 2015) to November 2018. Patients, indication, time to revision, prior methods of PDC correction, operative procedures, outcomes and PDC survival are described. In this period 355 PDC were inserted (134 surgical, 181 percutaneous by physician, 40 LAP). Thirty six LAP salvage operations were performed in 33 patients, 3 patients had 2 procedures. Patients were: male 22(61%), median age 63 years, diabetic 15(42%), 8(22%) history of heart disease, 12(33%) had prior abdominal surgery. Twenty two(61%) PDC had been inserted by physicians, 11(31%) by surgeons, and 3(8%) LAP. Physicians used straight tipped catheters while surgeons used curled tipped catheters exclusively. Indications for salvage were: poor outflow 26(72%), poor inflow & outflow 2(6%), labial/scrotal leaks 4(11%) and herniae 4(11%). Median time from PDC insertion to salvage was 110 days (range 42-1761). Twenty seven of 28 PDCs with flow issues had an abdominal X-ray with 20(74%) showing PDC malposition (outside a 90° arc centered over the midline) and 10 had (failed) radiologic manipulation. During LAP salvage all patients had atleast 1 corrective procedure and a mean of 2. Twenty six (72%) had 2, 8(22%) had 3, and 3(8%) had 4 procedures. Of the 10 patients requiring a single procedure 8 were HR, 1 CF and 1 OMT. The most common procedure was OMT (22), CF(20), AHX(9), HR(9), and PDC reposition (8). All PDC repositions were associated with an ancillary procedure and 5 PDCS were replaced (original PDC short, kinked, intraperitoneal cuff, and extruded superficial cuff). Twenty nine (88%) of 33 patients were on peritoneal dialysis (PD) at 30 days post procedure. Two developed genital leaks < 30 days and one at 518 days. Two had a successful LAP HR, 1 switched to hemodialysis. One patient developed poor PDC function after LAP umbilical HR requiring subsequent AHX and OMT and 1 patient despite correction of catheter flow refused to perform PD. Overall 31/33 (94%) patients were successfully returned to PD, 26(84%) with their originally inserted PDC. Five(14%) were treated for peritonitis < 30 days, all successfully, there was no other major complication. At study end 18(55%) were on PD, 8 transferred to hemodialysis (2 transplanted, 2 died, 2 relocated and 1 recovered function). Kaplan-Meier analysis after censoring for the latter showed PD technique survival of 90% at 180 days and 76% at 360 days. Laparoscopic salvage of malfunctioning PDC with advanced techniques is highly successful and should be an adjunct to any PD program. Multiple procedures are required during the salvage operation to restore PDC flow, however herniae/genital leaks can be repaired without additional procedures. Search for, and prophylactic correction of patent processus vaginalis, herniae and catheter fixation may reduce the need for subsequent procedures.