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

摘要

OBJECTIVE: 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. MATERIAL AND METHODS: 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. RESULTS: 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. CONCLUSIONS: One-port laparoscopic technique is a simple, safe and effective method for placement of peritoneal dialysis catheters.