Laparoscopic placement of peritoneal dialysis catheter: surgical method and results

Laparoskopsko postavljanje peritonejskoga katetera pokazalo se sigurnom i učinkovitom metodom zahvaljujući napredovanju instrumenata i tehnike. Na Klinici za kirurgiju KBC Osijek u posljednje dvije godine laparoskopskom tehnikom postavljeno je devet peritonejskih katetera. Operacije su se izvodile u općoj anesteziji. Kateter se uvodio kroz preperitonealni tunel u paramedijanoj lijevoj liniji do suprapubičnoga prostora koristeći 2 5mm troakara i mini laparoskopsku kameru, te se njegov izlazni kraj izvodio u lijevoj medioklavikulamoj liniji infraumbilikalno. Prosječno je trajanje operacije bilo 23 minute i nije bilo nikakvih intraoperacijskih komplikacija i morbiditeta. Jednom pacijentu istovremeno je napravljena hemioplastika umbilikalne hernije. S peritonejskom dijalizom započelo se dva tjedna nakon postavljanja katetera. Kod dva pacijenta pojavile su se komplikacije tipa leakage i okluzija katetera koje su uspješno riješene te se nakon toga mogla i dalje provoditi peritonejska dijaliza.Laparoscopic placement of peritoneal dialysis catheter has shown to be safe and effective due to improved instruments and method. During the period of 2 years, at the Clinic for Surgery of University Hospital Centre Osijek, 9 laparoscopic placements of peritoneal dialysis catheters were performed. The operations were performed under general anesthesia. Peritoneal dialysis catheter was passed through a preperitoneal tunnel until the tip was placed into the pelvis using 2 5mm ports and mini laparoscopic camera. Outer end of peritoneal dialysis catheter was pulled out in the left lower quadrant of abdomen. The mean operating time was 23 minutes. There were no intraoperative complications and morbidity. At the same time one umbilical hernia was repaired. Routine peritoneal dialysis started 2 weeks after its placement. In 2 cases complications such as leakage and catheter occlusion had been observed, however successfully resolved. This method has proven to be both safe and effective