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      Videolaparoscopic implantation of long-term peritoneal dialysis catheters.

      Surgical Endoscopy
      Adult, Aged, Catheters, Indwelling, Female, Humans, Insufflation, methods, Kidney Failure, Chronic, therapy, Laparoscopy, Male, Middle Aged, Nitrous Oxide, administration & dosage, Peritoneal Dialysis, instrumentation, Postoperative Complications, Video Recording

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          Abstract

          Implantation of peritoneal dialysis catheters by traditional laparotomy or trocar/guidewire techniques leaves the operator blind to the actual location and configuration of the peritoneal catheter tubing; it is associated with drainage dysfunction from catheter obstruction in 10-22% of catheter placements. This report presents a laparoscopic technique that allows accurate tube placement with complete visualization of the implant procedure. The peritoneal dialysis catheter was implanted through a port inserted in a paramedian location. Videoscopic monitoring was performed through a second port inserted in a pararectus location on the opposite side of the abdomen. Nitrous oxide gas was utilized for peritoneal insufflation thus permitting the procedure to be accomplished under local anesthesia. Follow-up of

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