Saad I Almulhim, MD FRCSC, Firas Shalak, MD, Salam Yazbeck, Ahmed AlKhunaizi, MD. Saudi Aramco Dhahran health center
The goal of this paper is to review our center’s experience with laparoscopic approach (LA) for peritoneal dialysis (PD) catheter insertion vs. open conventional insertion (OA) and compare it to the literature.
A retrospective chart analysis of all patients (40 patients) who underwent PD catheter insertion between January 2003 and November 2009 was done. There was no significant short-term outcome difference between LA and OA groups. The long-term catheter malfunction rate, however, was significantly less in the LA group compared to the OA group (p =0.015).
The difference in malfunction rates could be attributed to the fact that laparoscopy allowed complete omentectomy compared to limited omentectomy done in OA. Laparoscopy also allows positioning of the catheter tip in the pelvis and performing additional procedures if needed.
Laparoscopic approach for PD catheter insertion has a positive impact on their longevity. The difference in catheter survival may be related to the extent of omentectomy that is more easily achievable with LA when compared to omentectomy through a mini laparotomy OA. Larger studies are needed to further delineate the difference between OA and LA.
Program Number: P436