Laparoscopic preperitoneal tunneling technique using a novel device for peritoneal dialysis catheter placement
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ORIGINAL ARTICLE
Laparoscopic preperitoneal tunneling technique using a novel device for peritoneal dialysis catheter placement Bo Lin1 · Yueming Liu1 · Xiaogang Shen1 · Wangfang Chen1 · Xinxin Jiang1 · Qiang He1 Received: 17 January 2020 / Accepted: 19 July 2020 © Japanese Society of Nephrology 2020
Abstract Background We aimed to introduce the puncture technique based on a novel device for preperitoneal tunneling in laparoscopic PD catheter placement and to evaluate the safety and efficacy of this technique. Methods This novel device was used in our center from May 2016. We conducted a retrospective analysis of patients undergoing laparoscopic PD catheter placement. The traditional method was performed in 20 patients and the novel procedure in 18 patients. A straight Tenckhoff PD catheter was placed in all patients. Results No intraoperative complications were encountered in both groups. Compared the traditional technique group, the procedure based on the novel device had a shorter operative time (49.2 ± 11.8 vs 53.9 ± 12.5). One patient in the traditional tunneling group underwent catheter obstruction. There were no pericatheter leakage, exit site and subcutaneous infection, hernia and peritonitis in the early postoperative days. No mortality was observed in these patients. The 6-month survival rate of the catheter was 100%. Conclusions Laparoscopic preperitoneal tunneling technique is an effective way to implant intra-abdominal catheter. Our method based on a novel puncture device for preperitoneal tunneling is safe and efficient. Keywords Peritoneal dialysis · Catheter placement · Laparoscopic preperitoneal tunneling technique · Novel device
Introduction The growing population with end-stage renal disease (ESRD) worldwide emphasizes the need for renal-replacement therapy [1]. Peritoneal dialysis (PD) is a well-accepted dialysis modality of treating ESRD. However, the success of PD depends on the presence of a functional and durable long-term catheter. Peritoneal access complications including catheter obstruction or migration may lead to PD failure, and even force patients only to transfer from PD to hemodialysis (HD) [2]. Therefore, the catheter placement techniques may decide the therapeutic efficacy of PD for patients with ESRD. Different types of techniques had been described for catheter insertion, which include traditional open surgery, blind percutaneous, fluoroscopically guided percutaneous and * Qiang He [email protected] 1
Department of Nephrology, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou, China
laparoscopic procedures [3]. Laparoscopic catheter placement offered less pain and earlier recovery, and it was associated with a significant superior outcome in comparison with open insertion [4]. The combination of lysis of adhesions, omentopexy and catheter fixation offers the lowest rate of postoperative PD catheter dysfunction, so it is now being wildly used [5]. Laparoscopic catheter fixation technique had been demonstrated as a suc
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