Outcomes of Optimal Peritoneal Dialysis Catheter Placement Using a Laparoscopic Technique

Adrian Dan, MD, Andrew B Standerwick, MD, Shayda Mirhaidari, MD, John Zografakis, MD

Summa Health Systems, Northeast Ohio Medical University

Introduction – The purpose of this study is to evaluate the short term outcomes of 100 patients undergoing laparoscopic peritoneal dialysis catheter placement using the combination of described techniques for optimal placement.

Methods and Procedures – One hundred laparoscopic PD catheter placements were attempted over 5 years. Technique included placement of an adhesive betadine drape and betadine catheter site irrigation to avoid infection, use of fascia and muscle separating trocars to prevent hernia formation, preperitoneal catheter tunneling, omentopexy to the RUQ with trans-abdominal sutures, suture anchoring of the catheter to the lower midline, and flushing with heparinized saline. Patient demographics and short term complications or failures were recorded.

Results – Ninety-six catheters were successfully placed in 100 patients. Mean age of the patient population was 57.1 years. Sixty-four patients were male. Eighty-five procedures were completed in an outpatient setting. Complications within 30 days of placement occurred in 7 (7.3%) patients. These included adhesions, bleeding, and infection. Thirty-day mortality was 0%. Complications with the catheter or peritoneal dialysis >30 days after placement occurred in 13 (13.5%) patients requiring repositioning of 12 catheters. These complications led to the eventual removal of 10 (10.4%) catheters.

Conclusions – The laparoscopic placement of PD catheters using a combination of described techniques for optimal placement has acceptable perioperative and short term complication rates.

Session: Poster Presentation

Program Number: P627

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