Videolaparoscopic implantation of long-term peritoneal dialysis catheters

Implantation of peritoneal dialysis catheters by traditional laparotomy or trocar/guidewire techniques leaves the operator blind to the actual location and configuration of the peritoneal catheter tubing; it is associated with drainage dysfunction from catheter obstruction in 10-22% of catheter placements. This report presents a laparoscopic technique that allows accurate tube placement with complete visualization of the implant procedure. The peritoneal dialysis catheter was implanted through a port inserted in a paramedian location. Videoscopic monitoring was performed through a second port inserted in a pararectus location on the opposite side of the abdomen. Nitrous oxide gas was utilized for peritoneal insufflation thus permitting the procedure to be accomplished under local anesthesia. Follow-up of