Page 19 - WJOLS - Laparoscopic Journal

WJOLS

10.5005/jp-journals-10007-1110
REVIEW ARTICLE Single Port Laparoscopic Placement of Peritoneal Dialysis Catheter
Single-Port Laparoscopic Placement of

Peritoneal Dialysis Catheter

1 Tag Alsir Alamin Logman, RK Mishra
2
1 Specialist General Surgeon, Sudan, Oman
2 Senior Consultant Laparoscopic Surgeon, Professor in Minimal Access Surgery, Chairman and Director, World
Laparoscopic Hospital Pvt Ltd, DLF Cyber City, Gurgaon, Haryana, India

ABSTRACT

Recent advances in laparoscopic surgery have led to development of various laparoscopic techniques, both for treatment of malfunctioning
catheter and insertion of a dialysis catheter. Most of the techniques use two to four ports. Each port entry can cause weakness of the
abdominal wall, and hence possibility of leak or hernia. The technique of single port has been introduced for the management of
obstructed catheter and insertion of another catheter. In this article, we report and evaluate the results of single port technique in the
placement of tenckhoff catheter in chronic renal failure patients (in both adult patients and children).
Aim: To know the efficacy and safety of laparoscopic single port insertion of peritoneal dialysis catheter (tenckhoff) and its value in
catheter efficiency time, postoperative complications, hospital stay, operation time.
Materials and methods: A review of literature by searching in Google, Springer library facility available at the world laparoscopy hospital.
Characteristics of variables: Male : Female ratio, mean age, catheter survival rate, hospitalization period, early and late postoperative
complications, rate of hernia and leak, catheter migration, exit site infection.
Keywords: Laparoscopy, Tenckhoff, PD catheter.

DETAILS OF THE PROCEDURE The catheter position was checked, and patency insured
by flushing, and good inflow and outflow obtained.
The procedure is done under general anesthesia; patient
was positioned in supine and 5 mm port was inserted for The catheter was then heparinized and used for dialysis
telescope at the left lateral margin of the rectus muscle in after 2 weeks (Figs 1 and 2).
the upper quadrant at the midclavicular line. Mean operation time was 25 minutes.
Pneumoperitoneum was created through same port. An
intra-abdominal pressure was kept below 12 mm Hg during DISCUSSION AND RESULTS
the procedure. Laparoscopic Tenckhoff catheter insertion was introduced
Diagnostic laparoscopy was done; a 5 mm incision was in 1980. It has advantage over the open and percutaneous
made just to the left of the umbilicus by 2 cm, and a coiled methods. It has lower incidence of flow obstruction, less
catheter was inserted towards the pelvis in a 45º angle to chance of visceral injury and better patient compliance. The
the abdominal wall. single-port method was developed for the management of

Fig. 1: Coiled catheter used in laparoscopic method Fig. 2: Two types of PD catheters: Straight and Coiled

World Journal of Laparoscopic Surgery, January-April 2011;4(1):19-20 19