Laparoscopic placement of peritoneal dialysis catheters in children.
BACKGROUND
Peritoneal dialysis (PD) is preferred over hemodialysis. The aim of this study was to evaluate our experience with laparoscopic PD catheter placement and omentectomy in children.


METHODS
We reviewed all children (N = 21) who underwent laparoscopic placement of PD catheters and omentectomy. Ages ranged from 3 months to 16 years. Five children had previous major abdominal surgery and required extensive lysis of adhesions. During the same intervention, other surgical procedures were performed using laparoscopy or open technique, including umbilical hernia repair in 3, bilateral inguinal hernia repair in 3, ventral hernia repair in 2, gastrostomy in 4, kidney biopsy in 2, and cholecystectomy in 1.


RESULTS
Thirteen children received successful kidney transplantation and no longer needed dialysis. Two children still have functioning PD catheters. One patient developed membrane failure and was converted to hemodialysis. Four patients recovered enough renal function and no longer need dialysis. There were no complications related to the laparoscopic procedure.


CONCLUSIONS
Laparoscopy is ideal for PD catheter placement. It facilitates omentectomy, and it allows for the catheter to be placed in the proper position under direct vision and for lysis of adhesions to increase peritoneal surface. Other abdominal procedures can be performed laparoscopically at the same time.
Stringel
Gustavo
G
Department of Surgery, Division of Pediatric Surgery, Maria Fareri Children's Hospital, Westchester Medical Center, New York Medical College, Valhalla, NY 10595, USA. GStringel@aol.com
McBride
Whitney
W
Weiss
Robert
R
D000293:Adolescent; D002404:Catheterization / Q000009:adverse effects / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D017081:Cholecystectomy, Laparoscopic / Q000379:methods; D005260:Female; D005774:Gastrostomy / Q000379:methods; D006552:Hernia, Inguinal / Q000150:complications / Q000601:surgery; D006801:Humans; D007223:Infant; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy; D016030:Kidney Transplantation; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D009852:Omentum / Q000601:surgery; D010530:Peritoneal Dialysis / Q000009:adverse effects / Q000379:methods*; D010538:Peritonitis / Q000209:etiology; D000267:Tissue Adhesions / Q000150:complications / Q000601:surgery