Two-port laparoscopic placement of a peritoneal dialysis catheter using guideline-based trans-rectus insertion,...

We describe a simple modification of the two-port laparoscopic technique for peritoneal dialysis (PD) catheter placement incorporating guideline-recommended trans-rectus insertion and dedicated exit-site design. A 5-mm trocar is inserted through a small trans-rectus incision using an open (Hasson) technique and subsequently serves as the final catheter insertion site. After placement of the first port, a second 5-mm port is safely inserted at the planned superficial cuff site under laparoscopic guidance and subsequently serves as the camera port for the remainder of the procedure. After laparoscopic inspection, the PD catheter is introduced along an oblique trans-rectus pathway to enhance catheter stability, and the superficial cuff is secured at the port site. The catheter is then directed through a subcutaneous tunnel and exteriorized through a small exit site. This modification provides a simple and reproducible option for PD catheter placement.