Introduction of advanced laparoscopy for peritoneal dialysis catheter placement and the outcome in a University Hospital

J.H.H. van Laanen, E.J. Litjens, M. Snoeijs, M.M. van Loon, A.G. Peppelenbosch*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background Peritoneal dialysis (PD) catheters can be obstructed by omental wrapping or migration, leading to catheter malfunction. Multiple catheter placement techniques have been described. Advanced laparoscopy with fixation of the catheter and omentum has been reported to improve functional outcome compared to basic laparoscopy without fixation. This feasibility study describes surgical technique, complications, and comparison of the functional outcome of advanced versus basic laparoscopic catheter placement. Methods Between July 2016 and April 2019, the advanced laparoscopy technique was applied in all eligible patients. Two experienced surgeons placed the catheters in a standardized procedure. Peri-operative complications and functional outcome of the catheter were scored. Results were compared to a historical cohort retrieved from our RCT performed earlier using basic laparoscopy. Findings The basic laparoscopic group (BLG) consisted of 46 patients and the advanced laparoscopic group (ALG) of 32. Complication rate in both groups was similar and low with 7% in the BLG and 6% in the ALG (p = 1.0). There was a trend toward better functional catheter outcome in the ALG (88%) compared to the BLG (70%) (p = 0.1). Part of the catheter failures in the ALG could be related to the learning curve. After revision surgery, 94% of patients in the ALG had a functional catheter. These findings lead to the set-up of a multi-center randomized-controlled trial, currently running, comparing basic to advanced laparoscopic techniques.
Original languageEnglish
Pages (from-to)1391-1398
Number of pages8
JournalInternational Urology and Nephrology
Volume54
Issue number6
Early online date18 Oct 2021
DOIs
Publication statusPublished - Jun 2022

Keywords

  • Peritoneal dialysis
  • Surgical technique
  • Advanced laparoscopy
  • Functional outcome
  • Omentopexy
  • Catheter fixation
  • SURGICAL PLACEMENT
  • COMPLICATIONS
  • OMENTOPEXY

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