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Modified laparoscopic placement of peritoneal dialysis catheter with intra-abdominal fixation

  • Nephrology – Original Paper
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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.

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References

  1. El Nahas AM, Bello AK (2005) Chronic kidney disease: the global challenge. Lancet 365:331–340

    Article  Google Scholar 

  2. Collins AJ, Foley RN, Chavers B, Gilbertson D, Herzog C, Ishani A, Johansen K, Kasiske BL, Kutner N, Liu J, St Peter W, Guo H, Hu Y, Kats A, Li S, Li S, Maloney J, Roberts T, Skeans M, Snyder J, Solid C, Thompson B, Weinhandl E, Xiong H, Yusuf A, Zaun D, Arko C, Chen SC, Daniels F, Ebben J, Frazier E, Johnson R, Sheets D, Wang X, Forrest B, Berrini D, Constantini E, Everson S, Eggers P, Agodoa L (2015) US Renal Data System 2014 annual data report: epidemiology of kidney disease in the United States. Am J Kidney Dis 65(6 suppl 1):A7

    Google Scholar 

  3. Gokal R (1996) CAPD overview. Perit Dial Int 16(suppl 1):S13–S18

    PubMed  Google Scholar 

  4. Fresenius Medical Care (2016) Annual report 2015: understand what counts. http://www.freseniusmedicalcare.com/fileadmin/data/com/pdf/investors/News___Publications/Annual_Reports/2015/FMC_AnnualReport_2015_en.pdf

  5. Moreiras-Plaza M, Martin-Baez IM, Blanco-Garcia R, Beato-Coo LV, Cossio-Aranibar CR (2014) New peritoneal catheters: new catheter problems? Perit Dial Int 34:556–561

    Article  PubMed  PubMed Central  Google Scholar 

  6. Haggerty S, Roth S, Walsh D, Stefanidis D, Price R, Fanelli RD, Penner T, Richardson W (2014) SAGES Guidelines Committee. Guidelines for laparoscopic peritoneal dialysis access surgery. Surg Endosc 28(11):3016–3045

    Article  PubMed  Google Scholar 

  7. Figueiredo A, Goh BL, Jenkins S, Johnson DW, Mactier R, Ramalakshmi S, Shrestha B, Struijk D, Wilkie M (2010) International Society for Peritoneal Dialysis. On behalf of the International Society for Peritoneal Dialysis. Clinical practice guidelines for peritoneal access. Perit Dial Int 30:424–429

    Article  PubMed  Google Scholar 

  8. Ash SR (1981) Placement of the Tenckhoff peritoneal dialysis catheter under peritoneoscopic visualization. Dial Transplant 10:82–86

    Google Scholar 

  9. Adamson AS, Kelleher JP, Snell ME, Hulme B (1992) Laparoscopic placement of CAPD catheters: a review of one hundred procedures. Nephrol Dial Transplant 7:855–857

    CAS  PubMed  Google Scholar 

  10. Crabtree JH (2014) SAGES guidelines for laparoscopic peritoneal dialysis access surgery. Surg Endosc 28(11):3013–3015

    Article  PubMed  Google Scholar 

  11. Bay WH, Cerilli GJ, Perrine V, Powell S, Erlich L (1983) Analysis of a new technique to stabilize the chronic peritoneal dialysis catheter. Am J Kidney Dis 2:133–135

    Article  Google Scholar 

  12. Frost JH, Bagul A (2012) A brief recap of tips and surgical manoeuvres to enhance optimal outcome of surgically placed peritoneal dialysis catheters. Int J Nephrol 2012:1–7

    Article  Google Scholar 

  13. Popovich RP, Moncrief JW, Nolph KD, Ghods AJ, Twardowski ZJ, Pyle WK (1978) Continuous ambulatory peritoneal dialysis. Ann Intern Med 88:449–456

    Article  CAS  PubMed  Google Scholar 

  14. Ash SR (1990) Chronic peritoneal dialysis catheters: effects of catheter design, materials, and location. Semin Dial 3:39–46

    Article  Google Scholar 

  15. Rubin J, Adair CM, Raju S, Bower JD (1982) The Tenckhoff catheter for peritoneal dialysis—an appraisal. Nephron 32:370–374

    Article  CAS  PubMed  Google Scholar 

  16. Crabtree JH, Fishman A (2005) A laparoscopic method for optimal peritoneal dialysis access. Am Surg 71:135–143

    PubMed  Google Scholar 

  17. McIntosh G, Hurst PA, Young AE (1985) The ‘omental hitch’ for the prevention of obstruction to peritoneal dialysis catheters. Br J Surg 72:880

    Article  CAS  PubMed  Google Scholar 

  18. Barone GW, Lightfoot ML, Ketel BL (2002) Technique for laparoscopy-assisted complicated peritoneal dialysis catheter placement. J Laparoendosc Adv Surg Tech A 12:53–55

    Article  PubMed  Google Scholar 

  19. Numanoglu A, Rasche L, Roth MA, McCulloch MI, Rode H (2008) Laparoscopic insertion with tip suturing, omentectomy, and ovariopexy improves lifespan of peritoneal dialysis catheters in children. J Laparoendosc Adv Surg Tech A 18:302–305

    Article  PubMed  Google Scholar 

  20. Harissis HV, Katsios CS, Koliousi EL, Ikonomou MG, Siamopoulos KC, Fatouros M, Kappas AM (2006) A new simplified one port laparoscopic technique of peritoneal dialysis catheter placement with intra-abdominal fixation. Am J Surg 192:125–129

    Article  PubMed  Google Scholar 

  21. Kao CY, Chuang JH, Lee SY (2014) A new simplified one-port laparoscopic technique for peritoneal dialysis catheter placement. Perit Dial Int 34(1):109–113

    Article  PubMed  PubMed Central  Google Scholar 

  22. Soontrapornchai P, Simapatanapong T (2005) Comparison of open and laparoscopic secure placement of peritoneal dialysis catheters. Surg Endosc 19:137–139

    Article  CAS  PubMed  Google Scholar 

  23. Lu CT, Watson DI, Elias TJ, Faull RJ, Clarkson AR, Bannister KM (2003) Laparoscopic placement of peritoneal dialysis catheters: 7 years experience. ANZ J Surg 73:109–111

    Article  PubMed  Google Scholar 

  24. Bar-Zohar D, Sagie B, Lubezky N, Blum M, Klausner J, Abu-Abeid S (2006) Laparoscopic implantation of the Tenckhoff catheter for the treatment of end-stage renal failure and congestive heart failure: experience with the pelvic fixation technique. Isr Med Assoc J 8:174–178

    PubMed  Google Scholar 

  25. Chen JC, Lee WJ, Liu TP (2014) Modified laparoscopic technique for fixation of peritoneal dialysis catheter. Surg Laparosc Endosc Percutan Tech 24(4):e146–e150

    Article  PubMed  Google Scholar 

  26. Leblanc M, Ouimet D, Pichette V (2001) Dialysate leaks in peritoneal dialysis. Semin Dial 14:50–54

    Article  CAS  PubMed  Google Scholar 

  27. Ozener C, Bihorac A, Akoglu E (2001) Technical survival of CAPD catheter: comparison between percutaneous and conventional surgical techniques. Nephrol Dial Transplant 16:1893–1899

    Article  CAS  PubMed  Google Scholar 

  28. Gadallah MF, Pervez A, El-Shahawy MA, Sorrells D, Zibari G, McDonald J, Work J (1999) Peritoneoscopic versus surgical placement of peritoneal dialysis catheters: a prospective randomized study on outcome. Am J Kidney Dis 33:118–122

    Article  CAS  PubMed  Google Scholar 

  29. Napoli M, Russo F, Mastrangelo F (2000) Placement of peritoneal dialysis catheter by percutaneous method with the Veress needle. Adv Perit Dial 16:165–169

    CAS  PubMed  Google Scholar 

  30. Nahman NS Jr, Middendorf DF, Bay WH, McElligott R, Powell S, Anderson J (1992) Modification of the percutaneous approach to peritoneal dialysis catheter placement under peritoneoscopic visualization: clinical results in 78 patients. J Am Soc Nephrol 3:103–107

    PubMed  Google Scholar 

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Acknowledgements

This study was funded by Grants from the Major projects of Zhejiang Science and Technology Department (No. 2014C03047-2), Zhejiang Provincial Natural Science Foundation of China (Nos. LZ17H050001 and LY16H050005) and Zhejiang Medical Technology Project (No. 2016KYB017).

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Authors and Affiliations

  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

    Quanquan Shen, Xinxin Jiang, Xiaogang Shen, Qiudi Tu, Wangfang Chen & Qiang He

  2. Department of Biochemistry II, Ruhr-University Bochum, Bochum, Germany

    Fangyan Yu

  3. Department of Rehabilitation Medicine, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, People’s Republic of China

    Qing Ye

  4. Renal Division, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Tapas Ranjan Behera

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  1. Quanquan Shen
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  2. Xinxin Jiang
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  3. Xiaogang Shen
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  4. Fangyan Yu
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  5. Qiudi Tu
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  7. Qing Ye
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  8. Tapas Ranjan Behera
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  9. Qiang He
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Corresponding author

Correspondence to Qiang He.

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Conflict of interest

The authors declare that they have no conflict of interest in relation to this article.

Ethical approval

All procedures performed in studies involving human participant were in accordance with the ethical standards of the Institutional Review Board of Zhejiang Provincial People’s Hospital and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in this study.

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Shen, Q., Jiang, X., Shen, X. et al. Modified laparoscopic placement of peritoneal dialysis catheter with intra-abdominal fixation. Int Urol Nephrol 49, 1481–1488 (2017). https://doi.org/10.1007/s11255-017-1593-z

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  • DOI: https://doi.org/10.1007/s11255-017-1593-z

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