A PRACTICAL APPROACH TO LAPAROSCOPIC SURGERY FOR MALFUNCTIONING PERITONEAL-DIALYSIS CATHETERS

Peritoneal dialysis is widely accepted for the chronic management of e nd-stage renal disease but is associated with as high as a 70% complic ation rate including a significant problem with peritoneal dialysis ca theter flow obstruction, The application of laparoscopic surgical tech niques has revolutionized the surgical approach to peritoneal dialysis catheter-related dysfunction, However, the specific laparoscopic surg ical technique varied among the reported literature. This lack of a st andard laparoscopic surgical approach to obstructed peritoneal dialysi s catheters prompted us to review and compare our specific technique a nd experience in 17 patients with 10 recent reported series, We specif ically examined for insufflation techniques, access port placements an d closures, timing postoperatively for reinstituting peritoneal dialys is, wound complications, and overall long-term success rates for perit oneal dialysis catheter salvage.