[The role of the surgeon in a domiciliary peritoneal dialysis program]

The Authors report their surgical experience with 54 ESRD patients treated with peritoneal dialysis (PD). Guidelines on videolaparoscopic surgical treatment have been described and in 13 patients peritoneal catheter (PC) was inserted by videolaparoscopy (VL). They performed five VL cholecystectomies, in four cases combined with the PC insertion, in one PD patient without PD interruption. In three cases VL was useful in diagnosis and treatment of PC malfunction. A protocol has been done to treat hernias or laparocele before starting PD or during the course of PD and to prevent their recurrence. Two patients were operated for hernia or laparocele before PC insertion, seven patients during PC insertion. Seven patients were operated for hernia or laparocele developed during PD treatment, one of them in emergency for intestinal strangulation. One patient was operated for epigastric laparocele after an hypogastric laparocele correction. Prosthetic mesh repair was performed in every patient.