title: Laparoscopic-assisted catheter insertion for continuous ambulatory peritoneal dialysis: A case report of simple technique for optimal placement.
abstract: A 40-year-old male underwent tube placement surgery for continuous ambulatory peritoneal dialysis (CAPD). A 2-cm skin incision was made, and the peritoneum was reflected enough to perform secure fixation. A swan-necked, double-felted silicone CAPD catheter was inserted, and the felt cuff was sutured to the peritoneum to avoid postoperative leakage. An adequate gradient for tube fixation to the abdominal wall was confirmed. The CAPD tube was passed through a subcutaneous tunnel. Aeroperitoneum was induced to confirm that there was no air leakage from the sites of CAPD insertion. Two trocars were placed, and we confirmed that the CAPD tube led to the rectovesical pouch. Tip position was reliably observed laparoscopically. Optimal patency of the CAPD tube was confirmed during surgery. Placement of CAPD catheters by laparoscopic-assisted surgery has clear advantages in simplicity, safety, flexibility, and certainty. Laparoscopic technique should be considered the first choice for CAPD tube insertion.
authors.affiliation: Tomohide Hori, Masaya Nakauchi, Fumitaka Oike, Takahiro Tanaka, Daigo Gunji, Noriyuki Okada, Department of Surgery, Mitsubishi Kyoto Hospital, Kyoto 615-8507, Japan.
authors.forename: Tomohide
authors.initials: T
authors.lastname: Hori
authors.forename: Masaya
authors.initials: M
authors.lastname: Nakauchi
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Nagao
authors.forename: Fumitaka
authors.initials: F
authors.lastname: Oike
authors.forename: Takahiro
authors.initials: T
authors.lastname: Tanaka
authors.forename: Daigo
authors.initials: D
authors.lastname: Gunji
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Okada
keywords: Continuous ambulatory peritoneal dialysis; Dialysis catheter; Surgical technique; Tube insertion