Laparoscopic Peritoneal Dialysis Catheter Placement Research Articles

Laparoscopic peritoneal dialysis catheter insertion with omentopexy-sparing the omentum in children.

Continuous ambulatory peritoneal dialysis is an important modality of renal replacement therapy in children. Catheter dysfunction (commonly obstruction) is a major cause of morbidity and is a significant concern that hampers renal replacement therapy. As omentum is a significant cause of obstruction, some recommend routine omentectomy during insertion of the peritoneal dialysis catheter. Omentopexy rather than omentectomy has been described in adults to spare the omentum as it may be needed as a spare part in many conditions. Laparoscopic approach is commonly preferred as it provides global evaluation of the peritoneal space, proper location of the catheteral end in the pelvis and lesser morbidity due to inherent minimally invasive nature. The aim of this study is to present the technique of laparoscopic peritoneal dialysis catheter placement in children with concurrent omentopexy. We retrospectively evaluated our patients who underwent laparoscopic placement of peritoneal dialysis catheter with concomitant omentopexy or omentectomy. A total of 30 patients were enrolled who received either omentectomy (n = 18) or omentopexy (n = 12). Four catheters were lost in the omentopexy group (33%) and 3 in the omentectomy group (17%), but none were related to omental obstruction. Three out of 4 patients in the omentopexy group and 2 out of 3 patients in the omentectomy group had a previous abdominal operation as a potential cause of catheter loss. Previous history of abdominal surgery was present in 6 patients (50%) in the omentopexy group and 3 patients (17%) in the omentectomy group. As omentum was associated with catheter failure, omentectomy is commonly recommended. Alternatively, omentopexy can be preferred in children to spare an organ that may potentially be necessary for many surgical reconstructive procedures in the future. Laparoscopic peritoneal dialysis catheter placement with concomitant omentopexy appears as a feasable and reproducible technique. Although the catheter loss seems to be higher in the omentopexy group, none was related with the omentopexy procedure and may be related to the higher rate of history of previous abdominal operations in this group.

Laparoscopic Inguinal Hernia Repair and Synchronous Peritoneal Dialysis Catheter Placement: A Single-Center Experience.

Background: Peritoneal dialysis (PD) is a common method for treating end-stage renal disease (ESRD). Occurrence of inguinal hernia before and during PD is considered to be the main cause of treatment discontinuation, failure, and conversion to hemodialysis. In this study, we present a single-center experience about laparoscopic inguinal hernia repair and synchronous PD catheter placement and evaluated the feasibility and outcomes. Methods: During May 2018 to May 2022, a total of 216 consecutive patients with ESRD underwent laparoscopic PD catheter placement. Among them, 41 patients (27.7%) with coexistent inguinal hernia were included in this study. Individual information, complications, recurrent and new-onset hernias, and catheter survival were retrospectively analyzed. Results: Forty-one patients underwent laparoscopic inguinal hernia repair and synchronous PD catheter placement, 9 patients had bilateral inguinal hernia, and another 32 patients had unilateral inguinal hernia. The mean age was 46.49 years (range, 28-72 years), including 39 males and 2 females. There was no recurrent hernia and only 1 patient (2.4%) developed incisional hernia (trocar site hernia) which required hernia repair and discontinuation of PD. No postoperative complications were observed, such as bleeding, infection, and dialysate leakage. After a median follow-up of 37 months (20-58 months), there were no deaths and 97.6% (40/41) catheters were still working. Conclusions: Laparoscopic hernia repair and synchronous PD catheter placement is an effective and safe treatment for ESRD patients with coexisting inguinal hernia in virtue of low postoperative complications and high catheter survival.

Pilot study to investigate the effects of starting peritoneal dialysis 3 days after laparoscopic peritoneal dialysis catheter placement.

Pilot study to investigate the effects of starting peritoneal dialysis 3 days after laparoscopic peritoneal dialysis catheter placement.

Successful administration of eltrombopag in preparation for peritoneal dialysis catheter placement in a girl with MYH9-related disease.

MYH9-related disease is an autosomal dominant disorder characterized by macrothrombocytopenia, nephropathy, inclusion bodies in leukocytes, sensorineural hearing loss, and cataract. Severe cases require kidney replacement therapy in the patient's second decade of life; thrombocytopenia constitutes a major risk factor for hemorrhagic complications during dialysis initiation or kidney transplantation. Prophylactic platelet transfusion prior to surgery is commonly administered to affected patients in these cases. However, transfusion in such patients has limitations other than the general risk of allergic reactions and blood-borne infections; it may also trigger alloimmunization, leading to platelet transfusion resistance or the development of anti-donor antibodies in potential kidney transplant recipients. Here, we describe prophylactic administration of eltrombopag, an oral thrombopoietin receptor agonist, prior to laparoscopic peritoneal dialysis catheter placement in a 15-year-old girl with MYH9-related disease. Her platelet count was approximately 30 × 103/μL at baseline; it increased to 61 × 103/μL on the day before surgery, thereby avoiding the need for platelet transfusions. There were no major bleeding or adverse events associated with eltrombopag administration. Thus, eltrombopag may be a safe and effective alternative to prophylactic platelet transfusions in patients with MYH9-related disease.

P-058 IMMEDIATE USE OF PERITONEAL DIALYSIS AFTER SIMULTANEOUS LAPAROSCOPIC PLACEMENT OF PERITONEAL DIALYSIS CATHETER AND INGUINAL HERNIA REPAIR

Abstract Background Peritoneal dialysis is accepted renal placement therapy for end-stage renal disease (ESRD). Managing inguinal hernia in peritoneal dialysis (PD) patient is not standardized. Moreover, the occurrence of occult hernia post PD placement needs surgical planning. This work aims to report the outcome of simultaneous laparoscopic placement od PD catheter and transabdominal preperitoneal (TAPP) repair of inguinal hernia. Methods All patients underwent laparoscopic PD catheter placement for ESRD from September 2016 to July 2021 were reviewed. Patients who underwent Concurrent Laparoscopic Inguinal Herniorraphy and Laparoscopic PD catheter placement were involved. PD with inflow measurement of the amount and should be below the incised peritoneum by 1 inch and smooth inflow and outflow without leakage. The amount raised gradually in two weeks to reach the targeted PD. Results Laparoscopic PD catheter placement was inserted for 13 patients with inguinal hernia. Two patients had bilateral inguinal hernia, one patient with umbilical hernia, and one patient diagnosed with hernia intraoperatively. The safe amount of dialysate fluid was from 400 to 600ml. There was no mortality, intraoperative complications or fluid dialysis leak. One patient had catheter displacement which was repositioned laparoscopically. Three catheters were removed due to non-compliance. No hernia recurrence observed. Conclusion Simultaneous laparoscopic PD catheter placement and TAPP repair herniorrhaphy with immediate use of PD is safe and effective. Our surgical approach allows using minimal invasive technique in the management of both PD catheter placement and inguinal hernia repair without delaying PD.

A novel technique of sutureless omentopexy during dual-incision laparoscopic peritoneal dialysis catheter insertion to prevent catheter dysfunction due to omental wrapping.

Omental wrapping (OW) is the leading cause of obstruction of the peritoneal dialysis (PD) catheter, which interferes with dialysis treatment. Routinely or selectively performing omentopexy during laparoscopic PD catheter placement has been suggested to prevent OW. However, most of the published techniques for performing this adjunctive procedure require additional incisions and suturing. Herein, we aimed to report our experience in performing omentopexy with a sutureless technique during dual-incision PD catheter insertion. We also performed a comparative analysis to assess the benefit/risk profile of routine omentopexy in these patients. This retrospective study enrolled 469 patients who underwent laparoscopic PD catheter insertion. Their demographic characteristics and operative details were collected from the database of our institution. Omentopexy was performed by fixing the inferior edge of the omentum to the round ligament of the liver using titanium clips. For analysis, the patients were divided into the omentopexy group and the non-omentopexy group. We also reviewed the salvage management and outcomes of patients who experienced OW. The patients were categorized into the omentopexy (n = 81) and non-omentopexy (n = 388) groups. The patients in the non-omentopexy group had a higher incidence of OW, whereas no patient in the omentopexy group experienced this complication (5.2% vs. 0.0%, p = 0.033). The median operative time was 27min longer in patients who underwent omentopexy than in those who did not [100 (82-118) min vs. 73 (63-84) min, p < 0.001]. One patient had an intra-abdominal hematoma after omentopexy and required salvage surgery to restore catheter function. The complication rate of omentopexy was 1.2% (1/81). Sutureless omentopexy during laparoscopic PD catheter insertion is a safe and reliable technique that does not require additional incisions and suturing. Routinely performing omentopexy provides clinical benefits by reducing the risk of catheter dysfunction due to OW.

Feasibility and Safety of Laparoscopic Placement of Peritoneal Dialysis Catheter Using Percutaneous Endoscopic Gastrostomy Device.

We developed a novel technique of peritoneal dialysis (PD) catheter placement using an existing device originally utilized to insert a percutaneous endoscopic gastrostomy tube. We investigated the feasibility and safety of the procedure. This study included 21 consecutive patients who underwent laparoscopic placement of PD catheter between August 2021 and December 2021. We retrospectively investigated the clinical variables and perioperative results. The laparoscopic procedure was successfully performed in all patients. The duration of surgery was 21 (18-37) minutes. All patients could start PD within the seventh postoperative day. However, 1 patient had peri-catheter leakage due to exit-site infection. There were no patients with catheter migration, catheter obstruction, peritonitis, procedure-related death, and withdrawal of PD. The laparoscopic placement PD catheter using percutaneous endoscopic gastrostomy device was feasible and safe. (128 words).

Preperitoneal Local Anesthesia Technique in Laparoscopic Peritoneal Dialysis Catheter Placement.

Background and Objectives:Peritoneal dialysis is an excellent treatment for end-stage renal disease. Peritoneal dialysis is more advantageous if the catheter is positioned laparoscopically with omentopexy. General anesthesia is required for laparoscopic peritoneal dialysis catheter placement. General anesthesia is associated with increased postoperative morbidity and mortality in high-risk patients. In this retrospective study, the results of laparoscopic placement of peritoneal dialysis catheter under preperitoneal local anesthesia technique and sedation are presented for end-stage renal disease patients not fit for general anesthesia.Methods:We recruited 13 patients for laparoscopic placement of peritoneal dialysis catheter out of 99 end-stage renal disease patients who presented at a local tertiary hospital. The selection criteria were based on the American Society of Anesthesiologists classification III or above and patients unfit for general anesthesia.Results:Laparoscopic placement of peritoneal dialysis catheter was performed on 99 patients, and 13 patients were unfit for general anesthesia. Laparoscopic placement of peritoneal dialysis catheter and omentopexy were performed on these 13 patients together with capnoperitoneum, under preperitoneal local anesthesia technique and sedation. Three catheters were removed due to exit-site infection. One patient died after 2 years due to cardiac disease. The remaining patients continued with peritoneal dialysis. No omental entrapment, catheter migration, or other complications were encountered.Conclusion:Laparoscopic placement of peritoneal dialysis catheter under preperitoneal local anesthesia technique and sedation was successful for high-risk patients unfit for general anesthesia. This technique can be expanded for healthy patients to avoid general anesthesia complications, reduce costs, and speed recovery.

Outcomes of Laparoscopic Peritoneal Dialysis Catheter Placement Using an Optimal Placement Technique.

Background:Peritoneal dialysis (PD) is a widely employed renal replacement modality. A prospective study was conducted to determine the short-term and midterm outcomes and complication rates associated with a standardized optimal laparoscopic peritoneal dialysis catheter placement technique.Methods:All patients undergoing laparoscopic PD catheter placement by one surgeon using our standardized method over a 5-year period were entered into a prospective database. Patients were evaluated preoperatively and postoperatively through office visits. Development of complications was assessed using follow up telephone or mail surveys.Results:A total of 100 patients with a mean age of 56 years underwent laparoscopic PD catheter placement over the 5-year study period. In total, 103 laparoscopic PD catheter placement attempts were made in 100 patients. Placement was successful in 98 (95.1%) attempts and no placement required conversion to an open operation. Omentopexy was performed in 82 (83.7%) patients. There was no mortality reported within 30 days of the index operation. For patients who successfully underwent laparoscopic PD placement, early complications developed in 9 (9.2%) patients, of which 6 (6.1%) complications were directly related to the PD catheter. Midterm complications developed in 25 (25.5%) patients. Complication-related catheter repositioning was required for 12 (12.2%) catheters and catheter-related complication removal was required for 18 (18.4%) catheters.Conclusion:Laparoscopic placement of PD catheters can be successfully performed using a combination of described standardized laparoscopic maneuvers for optimal placement resulting in acceptable perioperative and short and midterm complication rates with negligible mortality rates.

Quantifying the risk of insertion-related peritoneal dialysis catheter complications following laparoscopic placement: Results from the North American PD Catheter Registry

Peritoneal dialysis (PD) is a more cost-effective therapy to treat kidney failure than in-center hemodialysis, but successful therapy requires a functioning PD catheter that causes minimal complications. In 2015, the North American Chapter of the International Society for Peritoneal Dialysis established the North American PD Catheter Registry to improve practices and patient outcomes following PD catheter insertion. The objective of this study is to propose a methodology for defining insertion-related complications that lead to significant adverse events and report the risk of these complications among patients undergoing laparoscopic PD catheter insertion. Patients undergoing laparoscopic PD catheter insertion were enrolled at 14 participating centers in Canada and the United States and followed using a Web-based registry. Insertion-related complications were defined as flow restriction, exit-site leak, or abdominal pain at any point during follow-up. We also included infections or bleeding within 30 days of insertion, and any immediate postoperative complications. Adverse events were categorized as PD never starting or termination of PD therapy, delay in the start of PD therapy or interruption of PD therapy, an emergency department visit or hospitalization, or need for invasive procedures. Cause-specific cumulative incidence functions were used to estimate risk. Five hundred patients underwent laparoscopic PD catheter insertion between 10 November 2015 and 24 July 2018. The cumulative risk of insertion-related complications 6 months from the date of insertion that led to an adverse event was 24%. The risk of flow restriction, exit-site leak, and pain at 6 months was 10.2%, 5.7%, and 5.3%, respectively. PD was never started or terminated in 6.4% of patients due to an insertion-related complication. Leaks and flow restrictions were most likely to delay or interrupt PD therapy. Flow restrictions were the primary cause of invasive procedures. Fifty percent of the complications occurred before the start of PD therapy. Insertion-related complications leading to significant adverse events following laparoscopic placement of PD catheters are common. Many complications occur before the start of PD. Insertion-related complications are an important area of focus for future research and quality improvement efforts.

Selective Infracolic Omentecomy and Fixation Reduces Complications after Laparoscopic Assisted Peritoneal Dialysis Catheter Placement

Introduction Peritoneal dialysis (PD) as a treatment for patients with end-stage renal disease (ESRD) provides a competitive alternative to hemodialysis (HD). Long-term catheter survival remains challenging and techniques are not standardized. Advanced laparoscopic placement with fixation and omentectomy might increase catheter survival. The goal of our study was to evaluate if selective infracolic omentectomy and fixation reduced complications after CAPD catheter placement. Materials and Methods A prospective database of patients with CAPD catheter placement from March 2004 to March 2015 was analyzed. All procedures were performed laparoscopically assisted and under general anesthesia by a single surgeon. 78 patients were included, there were no exclusion criteria. Statistical analysis was performed with SPSS. Fisher exact test and log-rank test with calculation of P-value was executed. P-value of &lt;0.05 was considered significant. Results Of the 78 patients who underwent catheter placement, 53 (68%) were males and 25 (32%) were females. The mean age was 54 (ranged from 13 to 88 years). Selective infracolic omentectomy was performed in 32 patients if the momentum reached beyond the promontory. Non-resorbable sutures to fix the catheter were applied in 33 patients. The average duration of peritoneal dialysis was 21 months (range from ten days to 84 months). Omentectomy significantly reduced the incidence of catheter obstruction (3 vs. 11%, P=0.028) but not of catheter dislocation (19 vs. 30%, P=0.101). Omentectomy did not significantly increase the incidence of peritonitis (22 vs. 31%,P=0.133) or exit-site infection (16vs 17%, P=0.238). Catheter fixation with non-resorbable sutures reduced catheter dislocation (21 vs. 23%, P=0.226) and catheter obstruction( 12 vs.17%,P=0.223) with a significant reduction of peritonitis (15 vs. 29%, P=0.044) and no effect on exit-site infection (15 vs. 17%,P=0.251). Conclusion Laparoscopic PD catheter placement with selective omentectomy and fixation of the catheter to the abdominal wall is safe and feasible and leads to fewer complications. Key words: peritoneal, dialysis, catheter, complications, laparoscopy, omentectomy.

Peritoneal dialysis catheter placement as a mode of renal replacement therapy: Long-term results from a tertiary academic institution

Peritoneal dialysis as a mode of renal replacement therapy still has not been embraced widely as an alternative to hemodialysis. Furthermore, there is marked variability in peritoneal dialysis catheter insertion techniques and perioperative management within the United States. After the publication of best-demonstrated practices for peritoneal dialysis catheter placement, the utilization of peritoneal dialysis has increased significantly at our institution. We detail the long-term success of peritoneal dialysis catheter placement after the adoption of best-demonstrated practices. Retrospective chart review was performed on all patients who underwent laparoscopic peritoneal dialysis catheter placement using the best-demonstrated practice technique from January 2005 through December 2015. Preoperative patient demographic information, intraoperative variables, 30-day morbidity and mortality, and long-term catheter durability outcomes were investigated. A total of 457 patients met inclusion criteria. Four (0.9%) patients experienced an immediate postoperative complication requiring return to the operating room. There were no perioperative mortalities. A total of 298 (65.2%) patients were available for long-term follow-up; 221 (74.2%) patients are still alive, 76 (25.6%) patients are still undergoing peritoneal dialysis, 63 (21.1%) patients transitioned from peritoneal dialysis to hemodialysis, and 88 (29.5%) patients have undergone kidney transplantation. Based on Kaplan-Meier survival plots, 30% of patients will transition from peritoneal dialysis to hemodialysis after 5.5years of peritoneal dialysis and the median time from commencing peritoneal dialysis to kidney transplantation is 5.6years. Based on our institutional data, the adoption of best-demonstrated practices should provide long-term and reliable access to the peritoneal cavity. We recommend the adoption of these techniques to facilitate long-term peritoneal dialysis catheter survival.

Update on Peritoneal Dialysis: Core Curriculum 2016

Update on Peritoneal Dialysis: Core Curriculum 2016

Laparoscopic peritoneal dialysis catheter placement is associated with decreased deep organ infection and reoperation.

The optimal method for placement of peritoneal dialysis catheters (PDC) is unclear. The objective of this study was to compare the outcomes of laparoscopic and open surgical placement of PDC. Patients who underwent laparoscopic (LPD) and open (OPD) surgical placement of PDC between 2007 and 2011 were identified from the American College of Surgeons National Surgical Quality Initiative Project (NSQIP) dataset using current procedural terminology (CPT) and international classification of diseases 9th revision (ICD-9) codes. Perioperative outcomes were compared using Fisher's exact test for categorical variables, Student's t-test and Gamma regression were used for continuous variables. Catheter function was not reported in the dataset. There were 1,560 PDC procedures in our study and most were performed laparoscopically (89%). 83% of these procedures were performed by general surgeons, mostly, with the patients under general anesthesia (95%). OPD was associated with a higher rate of perioperative deep organ infection (3.5% vs. 1.1%, p = 0.02) and need for reoperation (10.4% vs. 5.0%, p = 0.007). Operative time was, however, significantly longer with LPD (53.3 vs. 45.5 minutes, p < 0.001). In multivariate analysis, OPD was independently associated with increased risk of perioperative deep organ infection (odds ratio (OR) 3.7,95%, Confidence Interval (CI) 1.3 - 10.2, p = 0.01) and reoperation (OR 2.3, 95% CI 1.3 - 4.1, p = 0.005). Laparoscopic PDC placement is more commonly performed and is associated with a lower risk of perioperative deep organ infection and reoperation than the open surgical approach. When possible, laparoscopic PDC placement might be preferable over open surgical placement.

Laparoscopic peritoneal dialysis catheter placement: four years experience with 100 patients

Laparoscopic peritoneal dialysis catheter placement: four years experience with 100 patients

Laparoscopic Peritoneal Dialysis Catheter Placement is Associated with Decreased Risk of Perioperative Peritonitis and Reoperation

Laparoscopic Peritoneal Dialysis Catheter Placement is Associated with Decreased Risk of Perioperative Peritonitis and Reoperation

Laparoscopic techniques enable peritoneal dialysis in the difficult abdomen.

Background and Objectives:Continuous ambulatory peritoneal dialysis has become an increasingly popular modality of renal replacement therapy. Laparoscopic placement of peritoneal dialysis catheters may help overcome previous barriers to peritoneal dialysis, such as previous abdominal surgical procedures or the presence of hernias, without incurring substantially greater risks.Methods:We performed a retrospective review of 120 consecutive patients who underwent attempted laparoscopic peritoneal dialysis catheter placement between July 2009 and June 2014 by a single surgeon. Patient and catheter characteristics and outcomes were compared between patients with and without complications, as well as between patients with a history of major abdominal surgery and those without such a history.Results:Laparoscopic peritoneal dialysis catheter placement was aborted in 4 patients because of an inability to safely achieve sufficient access to the abdominal cavity through dissection; these patients were excluded from subsequent analysis. The mean follow-up period was 18.8 ± 12.9 months. Fifty-five patients had a history of major abdominal surgery compared with 61 without such a history. No significant difference was observed with respect to age, race, sex, or body mass index between groups. Notably, more adjunctive procedures were required in patients with previous abdominal surgery, including adhesiolysis (60.0% vs 4.9%, P < .0001) and hernia repair (12.7% vs 1.6%, P = .026). Postoperative catheter complications were not significantly different between patients with and patients without a history of abdominal surgery (29.1% vs 32.8%, P = .667). Both unassisted (56.8% vs 65.0%, P = .397) and overall (72.7% vs 76.7%, P = .647) 1-year catheter survival rates were similar between patients with and patients without previous surgery, and the overall 1-year survival rate improved to 83.9% on exclusion of patients who stopped peritoneal dialysis for nonsurgical reasons.Conclusions:Laparoscopic peritoneal dialysis catheter placement offers a chance to establish peritoneal dialysis access in patients traditionally viewed as noncandidates for this modality. Despite the potential risks incurred because of additional procedures at the time of catheter placement in these complicated cases, these patients can achieve good long-term peritoneal dialysis access with an aggressive surgical approach.

A Modified Method in Laparoscopic Peritoneal Catheter Implantation: The Combination of Preperitoneal Tunneling and Pelvic Fixation

Introduction. Continuous ambulatory peritoneal dialysis (CAPD) is widely accepted for the management of end-stage renal disease (ESRD). Although not as widely used as hemodialysis, CAPD has clear advantages, especially those related to patient satisfaction and simplicity. Peritoneal dialysis (PD) catheter insertion can be accomplished by several different techniques. In this study, we aimed to evaluate our results obtained with peritoneal dialysis catheter placement by combination of pelvic fixation plus preperitoneal tunneling. Material and Methods. Laparoscopic peritoneal catheter implantation by combining preperitoneal tunneling and pelvic fixation methods was performed in 82 consecutive patients with end-stage renal disease. Sex, age, primary disease etiology, complications, mean duration of surgery, mean duration of hospital stay, morbidity, mortality, and catheter survival rates and surgical technique used were assessed. Analysis of catheter survival was performed using the Kaplan-Meier method. Results. Mean follow-up period was 28.35 ± 14.5 months (range of 13–44 months). Mean operative time was 28 ± 6 minutes, and mean duration of hospital stay was 3 ± 1 days. There were no conversions from laparoscopy to other insertion methods. None of the patients developed serious complications during surgery or the postoperative period. No infections of the exit site or subcutaneous tunnel, hemorrhagic complications, abdominal wall hernias, or extrusion of the superficial catheter cuff was detected. No mortality occurred in this series of patients. Catheter survival was found to be 92% at 3 years followup. Conclusions. During one-year followup, we had seven patients of migrated catheters due to separation of pelvic fixation suture from peritoneal surface, but they were reimplanted and fixated again laparoscopically with success. Over a three-year followup period, catheter survival was found to be 92%. In the literature, similar catheter survival rates without combination of the two techniques are reported. As a conclusion, although laparoscopic placement of PD catheters avoids many perioperative and early complications, as well as increasing catheter free survival period and quality of life, our results comparing to other studies in the literature indicate that different laparoscopic placement methods are still in debate, and further studies are necessary to make a more accurate decision.

Major Urologic Complication of Laparoscopic Peritoneal Dialysis Catheter Placement for Failed Pediatric Kidney Transplant

Major Urologic Complication of Laparoscopic Peritoneal Dialysis Catheter Placement for Failed Pediatric Kidney Transplant

451 LAPAROSCOPIC PERITONEAL DIALYSIS CATHETER PLACEMENT IN THE PEDIATRIC PATIENT

You have accessJournal of UrologyPediatrics: Congenital Anomalies - Kidney & Ureter1 Apr 2010451 LAPAROSCOPIC PERITONEAL DIALYSIS CATHETER PLACEMENT IN THE PEDIATRIC PATIENT Blake Palmer, Kristin Janosek-Albright, Dominic Frimberger, and Bradley Kropp Blake PalmerBlake Palmer More articles by this author , Kristin Janosek-AlbrightKristin Janosek-Albright More articles by this author , Dominic FrimbergerDominic Frimberger More articles by this author , and Bradley KroppBradley Kropp More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.523AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Laparoscopic placement of peritoneal dialysis catheters is well tolerated and described in adult chronic renal failure patients. We report our technique and series of laparoscopic placement of peritoneal dialysis catheters utilizing a single working port in the pediatric population. METHODS We reviewed all laparoscopic peritoneal dialysis catheters placed at our institution between January 2007 and July 2009. Data was collected on etiology of renal failure, perioperative and postoperative outcomes for each successive patient. RESULTS Twenty-two patients with acute or chronic renal failure had a laparoscopic peritoneal dialysis catheters placed. The average age was 9.9 years and included 16 males and 6 females. The renal failure etiology was posterior urethral valves (3), hemolytic uremic syndrome (3), multicystic dysplastic kidneys (3), polycystic kidneys (2), unknown (5), renal agenesis (1), Alport's (1), Wegner's (1), methylmalonic acidemia (1), IgA nephropathy (1), and nephrotic syndrome (1). The total in operative room time was 69.2 minutes on average. At the time of catheter placement, 3 patients required an omentectomy and 2 required lysis of adhesions. Six had a prior peritoneal dialysis catheter placed open and 7 had prior abdominal surgeries. Overall complications with the peritoneal dialysis catheters in the cohort were 21.1% and 15.8% required a revision. No irreversible or major complications occurred. CONCLUSIONS Laparoscopic placement of peritoneal dialysis catheters is safe, practical, and successful in the pediatric renal failure population. Outcomes are comparable to open and laparoscopic outcomes in the adult population. Oklahoma City, OK© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e178 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Blake Palmer More articles by this author Kristin Janosek-Albright More articles by this author Dominic Frimberger More articles by this author Bradley Kropp More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...