Laparoscopic salvage of malfunctioning Tenckhoff catheters

Alp Numanoglu, Mignon I McCulloch, Anne Van Der Pool, Alastair J W Millar, Heinz Rode
Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A 2007, 17 (1): 128-30

PURPOSE: Peritoneal dialysis is a practical and appropriate form of dialysis in developing countries, as patients can be trained to do this at home. The aim of this study was to assess the efficacy of laparoscopic techniques in managing malfunctioning Tenckhoff catheters in a supraregional nephrology and transplant center.

MATERIALS AND METHODS: Between 2001 and 2004, 43 patients required Tenckhoff catheter insertion (20 males and 23 females). The average age was 8.9 years (range, 2-17 years). Four patients had their catheter tip sutured to the pelvic peritoneum and 11 underwent omentectomy at initial insertion. Laparoscopic salvage was performed using two or three 5-mm ports. If required, the tip of the catheter could be inspected and cleaned by delivering it through one of the port sites. The catheter was then replaced in the abdomen with the tip lying in the pelvis. Twenty patients (6 males and 14 females) required surgical correction for malfunctioning catheters. Eleven underwent a total of 13 laparoscopic salvage operations, and 9 patients had open replacement of catheters.

RESULTS: The causes of malfunction identified in the laparoscopic group were occlusion by fimbriae (n = 4) or omentum (n = 1), peritonitis (n = 4), and displacement of catheter (n = 4). In the open replacement group 2 patients had peritonitis, 1 had occlusion due to fimbriae, and 1 due to omentum. Five had no cause identified. Re-look laparotomy and diathermy hemostasis of fimbriae was required in one patient due to bleeding from fimbriae following laparoscopic retraction of fimbriae from the peritoneal dialysis catheter.

CONCLUSION: Twenty of forty-three (46%) patients required Tenckhoff catheter salvage surgery. The laparoscopic approach enabled us to visualize the cause of malfunction and correct problems without reinsertion of a new catheter, as had been our previous practice.

Full Text Links

Find Full Text Links for this Article


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

Related Papers

Remove bar
Read by QxMD icon Read

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"