Effectiveness and Complications of Laparoscopic-assisted Insertion of the Peritoneal Dialysis Catheters

Hamed A AlWadaani

Abstract

Objective •

To evaluate the usefulness and complications of placement of laparoscopically assisted (LA) peritoneal dialysis catheter (PDC).

Study design

Cross sectional study.

Place & Duration of study

King Fahad Hofuf hospital, Al-Ahsa, Kingdom of Saudi Arabia, from December 2014 to November 2018.

Methodology

All patients with end stage renal failure (ESRF) requiring renal transplant, referred for inserting the PDC, were included. Patients not fit for general anesthesia and those who developed complications related to the pneumoperitoneum were excluded. Preoperative renal and liver functions test were performed when needed. Most of the patients were operated through single port. The postoperative outcome including complications were recorded. The data was analyzed by SPSS-19.

Results

Thirty one patients were included. Twenty-three (74.19%) were males and eight (25.8%) females (ratio - 4:1). The age of the patients was from 17-65 years (mean  46 + 11.2 year). In 25 (80.6%) patients, the laparoscopic procedure was performed through a single port. Other six (19.35%) required additional ports. In these patients, 35 operations were performed. Repositioning of the catheter was required in four patients who developed complications. The primary clinical success was noted in twenty-three (74.2%) and complications occurred in eight (25.8%) patients. One (3.2%) patient had blockage of catheter, one (3.2%) malposition, and one (3.2%) migration of the catheter. In one (3.2%) patient, the omental adhesions developed. Two (6.4%) patients had port-site infection and treated with systemic and local antibiotics.  Two (6.4%) patients developed peritonitis in whom the catheter was removed.

Conclusions•

The LA method to insert PDC is a good and easy approach that can be used safely. It is associated with low morbidity and a few complications related to the catheter that can be treated easily.

Key words

Laparoscopic peritoneal dialysis, Peritoneoscopy, End-stage renal failure (ESRF).