Mini‐laparoscopic placement of peritoneal dialysis catheter: New technique

Background:  Leakage remains a problem with all methods of catheter placement. We describe our experience with a new mini-laparoscopic technique for catheter placement in patients with end-stage renal failure. Patients and methods:  Between May 2002 and March 2004, 24 patients underwent mini-laparoscopic placement of peritoneal dialysis catheters. All patients had end-stage renal failure with difficult vascular access for haemodialysis. There were 11 men and 13 women with a mean age of 51.4 years (range: 18–75 years). Operative time, interval to initiation of successful peritoneal dialysis, postoperative pain management, resumption of diet and postoperative complications were recorded. Results:  The mean operative time was 32.3 min (range: 15–40 min). All patients were given a normal diet on the day of surgery. Postoperative pain was controlled with paracetamol tablets three times daily for 2–3 days. The mean hospital stay was 3.2 days (range: 3–4 days). No patients developed leakage either from the ports or around the catheter. Two (8.3%) patients had blockage of the catheter and underwent diagnostic laparoscopy and laparoscopic correction. Two (8.3%) patients had migration of the catheter which required laparoscopic repositioning. The follow-up range was between 2 and 22 months. Conclusion:  Mini-laparoscopic technique for placement of peritoneal dialysis catheter is unique because it uses only two ports. The catheter is made to exit via a 2 mm port site and does not require specially designed instruments.