title: [Laparoscopic management of peritoneal dialysis catheters].
abstract: BACKGROUND
  Peritoneal dialysis (PD) is one of the established methods for the management of patients with end-stage renal failure. Laparoscopy has been used to assist in the insertion of new catheters as well as for the salvage of malfunctioning peritoneal dialysis catheters (PDC).
  
  
  OBJECTIVE
  The purpose of this retrospective study was to review our experience in the utilization of laparoscopy for the management of PDC.
  
  
  METHODS
  We reviewed the charts of all consecutive patients who had undergone either a ap-assisted insertion of a PDC utilizing a modified peritoneoscopic Y-TEC [Medigroup, Inc, Oswego, Ill) technique (YT) under direct laparoscopic vision or laparoscopic-assisted procedures for the salvage of a malfunctioning PD catheter.
  
  
  RESULTS
  Twenty nine patients had undergone 43 procedures that included the insertion of a new PD catheter using the modified YT technique, YT with simultaneous adhesiolysis and omentectomy; YT with repair of an epigastric hernia, omentectomy, adhesiolysis and repositioning of PDC; and ravage and repositioning of the obstructed PD catheter in all patients who needed repositioning of the catheter, the PDC was fixed with an intraperitoneal suture to the lower anterior abdominal wall. Postoperatively, malfunction of the catheter was found in one patient due to reclotting of PDC caused by oozing as a result of extensive adhesiolysis. One patient needed emergent laparotomy due to small bowel perforation that was missed during a difficult laparoscopic adhesiolysis.
  
  
  CONCLUSIONS
  Laparoscopic surgery may be helpfuL for the diagnosis and the management of a malfunctioning PDC. A modified YT technique is safe and may be one of the alternative methods for the placement of a PDC.
authors.affiliation: Department of Surgery A, Meir Medical Center, Kfar Saba, Israel. neufeldd@clalit.org.il
authors.forename: David
authors.initials: D
authors.lastname: Neufeld
authors.forename: Zeev
authors.initials: Z
authors.lastname: Korzets
authors.forename: Jacques
authors.initials: J
authors.lastname: Bernheim
authors.forename: Baruch
authors.initials: B
authors.lastname: Shpitz
mesh_terms: D002404:Catheterization; D004868:Equipment Failure; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D010535:Laparoscopy / Q000379:methods*; D009852:Omentum / Q000601:surgery; D010530:Peritoneal Dialysis / Q000379:methods*; D012189:Retrospective Studies; D000267:Tissue Adhesions / Q000209:etiology / Q000601:surgery