[Laparoscopic placement of peritoneal dialysis catheter: description and results of a two-port technique].
OBJECTIVE
To test the feasibility, efficacy and safety of a new two port laparoscopic technique for dialysis catheter placement.


METHODS
From January 2006 to July 2009 51 patients underwent dialysis catheter placing using an original technique. All procedures were finished laparoscopically using two 12 mm-sized ports. Our technique bases on placing Oreopoulos-Zellerman catheter along a straight Guyon s guide with atraumatic tip, visually guaranting optimal placement. Catheter can be repositioned if desired by reentering the guide. Median follow-up was 25 months.


RESULTS
Mean operating time was 32 minutes (range 15-55 minutes). One patient suffered an immediate postoperative catheter obstruction that required surgical repositioning. No other technical intra or early postoperative complications related to technique were reported. Mean time to discharge 1.02 +/- 2.2 days. Catheter outflow failure rate was 7.6%. Conversion to haemodialysis due to peritonitis 13%. Peritonitis per patient/year was 0.27. Catheter 6 mo, 1 year and 2 year survival rate was 94%, 87% and 72%. Catheter migration rate was 4%. There was no peritoneal dialysis liquid leakage.


CONCLUSIONS
The two ports technique described is an easy and rapid procedure, with few complications and early discharge. Due to its reliability, offers good catheter function outcome.
Servicio de Urología, Hospital Clínic de Barcelona, Barcelona. edu_garcia_cruz@yahoo.com
E
E
García-Cruz
M
M
Vera-Rivera
J M
JM
Corral Molina
J M
JM
Mallafré-Sala
A
A
Alcaraz
D000328:Adult; D000368:Aged; D002404:Catheterization / Q000009:adverse effects / Q000379:methods*; D004312:Douglas' Pouch; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D005548:Foreign-Body Migration / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000628:therapy; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects / Q000295:instrumentation*; D010538:Peritonitis / Q000209:etiology / Q000517:prevention & control; D011028:Pneumoperitoneum, Artificial / Q000379:methods; D011446:Prospective Studies; D006435:Renal Dialysis; D014472:Umbilicus