Abstract
Background
Peritoneal dialysis is a life sustaining renal replacement therapy for patients with end stage renal disease. In comparison to hemodialysis it offers better mobility and independence to patients. A number of techniques including open, laparoscopic and fluoroscopy guided, and their modifications, have been described for intraperitoneal catheter insertion. We describe our technique and results of laparoscopic peritoneal dialysis (PD) catheter insertion at a tertiary care centre in India.
Case series
48 patients were referred from the department of nephrology at our centre for laparoscopic PD catheter insertion. A two port technique was used in 37 patients and three port technique was implemented in the rest for simultaneous adhesiolysis and/or omentectomy. A straight tip catheter was tunneled through the rectus muscle in all patients. Two patients had incisional hernia from a previous abdominal surgery which was repaired concomitantly with onlay meshplasty.
Results
The operative time ranged between 20 and 35 min under general anaesthesia. Three patients were subjected to urgent start dialysis of which one patient developed peridrain leak as an early complication which was managed conservatively. All other patients were commenced on peritoneal dialysis two weeks after surgery. There was no other surgical site occurrence or episodes of peritonitis reported in a 6 month follow up period with the department of nephrology.
Conclusion
In the era of minimal access surgery, the laparoscopic approach is feasible for widespread and safe use for PD catheter insertion. The benefits of PD can thus be made available to patients at civil hospitals even with a basic laparoscopy setup.
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Drs. Sameer Ashok Rege, Jayati Churiwala, Yogesh Takalkar, Yash Jain and Abhay Dalvi have no conflicts of interest or financial ties to disclose.
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Rege, S.A., Churiwala, J., Takalkar, Y. et al. Laparoscopic peritoneal dialysis catheter insertion: an oasis harnessed—experience and results at a tertiary care centre in India. Surg Endosc 37, 6491–6494 (2023). https://doi.org/10.1007/s00464-023-10154-2
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DOI: https://doi.org/10.1007/s00464-023-10154-2