COMPARATIVE STUDY
JOURNAL ARTICLE

Mini-laparoscopy-assisted placement of Tenckhoff catheters: an improved technique to facilitate peritoneal dialysis

Charlotte A Batey, J Jason Crane, Michael A Jenkins, Thomas D Johnston, Larry C Munch
Journal of Endourology 2002, 16 (9): 681-4
12490023

BACKGROUND AND PURPOSE: Despite its overall efficacy and patient satisfaction with it, peritoneal dialysis has a history of significant complications, which has contributed to the evolution in the technique from open laparotomy to minimally invasive placement of the catheters. Our goal was twofold: (1) to review our early experience with a technique of mini-laparoscopy-assisted (MLA) placement of dialysis catheters compared with open placement and (2) to demonstrate that urologists are able to provide a satisfactory procedure while concurrently developing and maintaining laparoscopic skills within a residency training program.

PATIENTS AND METHODS: The charts of the first 14 consecutive patients who underwent MLA placement of Tenckhoff dialysis catheters by a single surgeon (LCM) from January 1, 2000, through March 31, 2001, were reviewed. Postoperative narcotic analgesia, length of hospital stay, operative times, days until cycling, and rates of leakage, infection, and malfunction necessitating removal of catheters were compared with the corresponding data from 12 consecutive patients who underwent traditional open placement during the same time period. A telephone survey was performed to corroborate and supplement the findings from the chart review.

RESULTS: Differences in complications necessitating catheter removal were not significant. The difference in the mean operative times of 41.7 minutes in the MLA group and 55.7 minutes for open placement was statistically significant. Postoperatively, the MLA group used less narcotic analgesia, had shorter hospital stays, and returned earlier to usual activities. The incidence of leakage after catheter placement was greater in the open group, although this difference was not statistically significant.

CONCLUSIONS: The MLA technique of dialysis catheter placement appears to have similar or greater efficacy than the open technique. It is a viable teaching procedure, and with reusable 3-mm ports and shorter operative times, it is cost efficient as well.

Full Text Links

Find Full Text Links for this Article

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Trending Papers

Remove bar
Read by QxMD icon Read
12490023
×

Save your favorite articles in one place with a free QxMD account.

×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"