Quanquan Shen1, Xinxin Jiang1, Xiaogang Shen1, Fangyan Yu2, Qiudi Tu1, Wangfang Chen1, Qing Ye3, Tapas Ranjan Behera4, Qiang He5. 1. Department of Nephrology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, No. 158 Shangtang Road, Hangzhou, 310014, Zhejiang, People's Republic of China. 2. Department of Biochemistry II, Ruhr-University Bochum, Bochum, Germany. 3. Department of Rehabilitation Medicine, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, People's Republic of China. 4. Renal Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. 5. Department of Nephrology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, No. 158 Shangtang Road, Hangzhou, 310014, Zhejiang, People's Republic of China. qianghe@zju.edu.cn.
Abstract
PURPOSE: Peritoneal dialysis (PD) is a commonly accepted method of treating end-stage renal disease (ESRD). Various laparoscopic techniques for the placement of PD catheter have been described. In this study, we developed a novel modified laparoscopic technique for PD catheter placement and evaluated the early results. METHODS: A straight Tenckhoff PD catheter was placed employing the modified technique in 39 consecutive patients with ESRD from May 2013 to April 2016. The technique is laparoscopically guided intra-abdominal fixation of the PD catheter tip at one point by using suture passer hernia forceps. Individual information including sex, age, primary disease etiology, complications, surgical duration, morbidity, mortality and catheter survival was collected and analyzed. RESULTS: The modified laparoscopic procedure was effectively performed in all patients with a mean operative time of 45 ± 7 min. No conversions from laparoscopy to open surgery of catheter placement occurred. There was one case showing early pericatheter leakage. There were no serious complications, such as bleeding, abdominal wall hernias, distal catheter cuff extrusion and infections of the exit site or tunnel during surgery or the postoperative duration. No mortality was observed in this group of patients. The 6-month follow-up study showed 100% catheter-related complication-free survival. CONCLUSIONS: Our modified laparoscopic intra-abdominal fixation technique using suture passer hernia forceps is a simple and safe method for PD catheter placement and is effective in minimizing the risk of catheter migration.
PURPOSE: Peritoneal dialysis (PD) is a commonly accepted method of treating end-stage renal disease (ESRD). Various laparoscopic techniques for the placement of PD catheter have been described. In this study, we developed a novel modified laparoscopic technique for PD catheter placement and evaluated the early results. METHODS: A straight Tenckhoff PD catheter was placed employing the modified technique in 39 consecutive patients with ESRD from May 2013 to April 2016. The technique is laparoscopically guided intra-abdominal fixation of the PD catheter tip at one point by using suture passer hernia forceps. Individual information including sex, age, primary disease etiology, complications, surgical duration, morbidity, mortality and catheter survival was collected and analyzed. RESULTS: The modified laparoscopic procedure was effectively performed in all patients with a mean operative time of 45 ± 7 min. No conversions from laparoscopy to open surgery of catheter placement occurred. There was one case showing early pericatheter leakage. There were no serious complications, such as bleeding, abdominal wall hernias, distal catheter cuff extrusion and infections of the exit site or tunnel during surgery or the postoperative duration. No mortality was observed in this group of patients. The 6-month follow-up study showed 100% catheter-related complication-free survival. CONCLUSIONS: Our modified laparoscopic intra-abdominal fixation technique using suture passer hernia forceps is a simple and safe method for PD catheter placement and is effective in minimizing the risk of catheter migration.
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