Single-port laparoscopic insertion of peritoneal dialysis catheters in children

To assess the effectiveness and complication rate of laparoscopically placed peritoneal dialysis catheters using the single-port technique.

This is a prospective study conducted from 2002 to 2004. Children with established renal failure requiring insertion of a peritoneal dialysis catheter were included. The insertion was performed by a single surgeon using a single-port laparoscopic technique. Partial omentectomy was performed and the catheter accurately placed in the pelvis under vision. The catheter could then be used immediately postoperatively.

Twenty-two children (13F:9M) with a mean age of 9 years (range 1.0-17.5) had a peritoneal dialysis catheter inserted laparoscopically between 2002 and 2004. Mean time for insertion was 26 min (range 23-29 min). Ten (45%) catheters were used within 4 h. Early complications included a minor leak that resolved within 24 h, one exit-site infection that resolved with oral flucloxacillin, one blockage due to a fibrin clot that resolved with urokinase, and one blockage after 2 weeks due to adhesions (not omentum) that was revised.

Laparoscopic insertion of a peritoneal dialysis catheter allows accurate placement of the catheter under direct vision, immediate use postoperatively with minimum morbidity, and good cosmesis. The single-port laparoscopic technique is a safe, effective and quick technique for use in children.