Randomized prospective comparison of laparoscopic and open peritoneal dialysis catheter insertion

♦ Objective: To compare laparoscopic and conventional peritoneal dialysis catheter insertion with respect to post operative discomfort, complication rates, and catheter survival. ♦ Design: Randomized prospective study. ♦ Setting: Tertiary referral renal unit. ♦ Patients: Fifty patients commencing peritoneal dialysis. ♦ Intervention: Catheters were implanted laparoscopically or by a conventional surgical technique. ♦ Main Outcome Measures: The duration of surgery, hospital stay, pain scores, and analgesic requirements were recorded. Complications (early/late) and catheter survival were compared. ♦ Results: The conventional procedure was faster than the laparoscopic (14.3 vs 21.9 minutes, p < 0.0001). There was no difference in any other parameter assessed. ♦ Conclusions: The data suggest that the insertion techniques are equivalent, and that laparoscopic insertion does not reduce early complication rates.