Two plus one port laparoscopic assisted continuous ambulatory peritoneal dialysis insertion modified technique: a...

Area of Science:

• Nephrology
• Minimally Invasive Surgery
• Medical Devices

Background:

• Continuous ambulatory peritoneal dialysis (CAPD) is a renal replacement therapy for stage 5 chronic kidney disease.
• Tenckhoff catheter malposition is a common complication in CAPD.
• Standardized laparoscopic techniques for CAPD catheter insertion are lacking.

Purpose of the Study:

• To present a modified laparoscopic technique for Tenckhoff catheter insertion.
• To evaluate the efficacy of a two plus one port laparoscopic approach in preventing catheter malposition.
• To assess intraoperative and postoperative complications associated with the modified technique.

Main Methods:

• Retrospective case series of 49 patients undergoing CAPD catheter insertion.
• Utilized a modified two plus one port laparoscopic technique.
• Collected demographic, clinical, intraoperative, and postoperative data with 1-year follow-up.

Main Results:

• The modified laparoscopic technique resulted in no intraoperative complications.
• Postoperative complications included hematoma (2.04%), omental adhesion (16.3%), exit-site infection (14.28%), and peritonitis (4.08%).
• No Tenckhoff catheter malposition was observed at 1-year follow-up.

Conclusions:

• The two plus one port modified laparoscopic technique effectively prevents Tenckhoff catheter malposition by ensuring pelvic fixation.
• This technique offers a viable solution for improving CAPD outcomes.
• Further 5-year follow-up is recommended to assess long-term catheter survival.