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Laparoscopic-Assisted Seldinger Technique for Peritoneal Dialysis Catheter Insertion

Laparoscopic-Assisted Seldinger Technique for Peritoneal Dialysis Catheter Insertion

Published on: May 23, 2025

Peritoneal dialysis access: open versus laparoscopic surgical techniques.

Christine Hwang¹, Ingemar Davidson, Stefano Santarelli

¹1 Department of Surgery, University of Texas Southwestern Medical Center and Parkland Hospital, Dallas, Texas - USA.

The Journal of Vascular Access

|September 18, 2013

Summary

Choosing between open and laparoscopic techniques for peritoneal dialysis (PD) catheter placement depends on patient factors and resources. Laparoscopic methods are preferred for rescuing malfunctioning catheters and in patients with prior abdominal surgeries.

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Area of Science:

Nephrology
Surgical Techniques
Medical Devices

Background:

Debate persists regarding the superiority of open versus laparoscopic techniques for peritoneal dialysis (PD) catheter insertion.
The optimal approach for salvaging malfunctioning PD catheters remains a subject of discussion.

Purpose of the Study:

To compare the advantages and disadvantages of open and laparoscopic methods for PD catheter placement.
To provide guidance on selecting the most appropriate technique based on patient-specific criteria and available resources.

Main Methods:

Detailed description of open paramedian and two laparoscopic approaches for PD catheter insertion.
Evaluation of technique-specific pros and cons, considering patient characteristics, surgical team expertise, and institutional capabilities.

Main Results:

Laparoscopic technique generally involves longer operative times, increased costs, and requires general anesthesia.
Laparoscopic approach is advantageous for rescuing malfunctioning PD catheters and may expand PD candidacy for patients with previous abdominal surgeries.
Individualized patient assessment and institutional resources are critical for successful PD catheter placement.

Conclusions:

The choice between open and laparoscopic PD catheter placement should be individualized, not based on a single 'best' method.
Surgeons should be proficient in both techniques to optimize outcomes for each patient.
Laparoscopic surgery offers specific benefits in complex cases, such as catheter salvage and post-surgical patients.