Secure placement of continuous ambulatory peritoneal dialysis catheters under laparoscopic assistance

Laparoscopic surgical procedures were performed in 18 patients with end-sta ge renal disease for the placement of a Tenckhoff peritoneal dialysis cathe ter. Among them, 6 patients had received previous lower abdominal surgical treatment and 3 patients underwent laparoscopic rescue of dysfunctional Ten ckhoff catheters. The operating time was between 40 and 80 minutes (median, 50 minutes). After a median follow-up period of 11 months, the short-term results revealed that no significant morbidity was associated with this pro cedure, and all catheters except two functioned well postoperatively. One o f the catheters was not functional because of the patient's death, and the other one was removed because of persistent peritonitis. Laparoscopic secur e placement of continuous ambulatory peritoneal dialysis catheters appears to be a simple, safe, and viable procedure, even in patients with previous lower-abdominal operations. The same technique can be used to rescue dysfun ctional catheters that are displaced or obstructed by adhesion and omental wrapping, thus increasing catheter longevity.