Fluoroscopic Manipulation is also useful for Malfunctioning Swan-Neck Peritoneal Catheters

Plaza, Mercedes Moreiras; Rivas, Moisés Casal; Dominguez-Viguera, Luis

doi:10.1177/089686080102100214

Cited by 12 publications

(5 citation statements)

References 9 publications

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“…Catheter tip migration still accounts for a substantial number of catheter failures in both openly and laparoscopically placed CAPD catheters. When conservative measures fail to attain a response, either an open or a laparoscopic procedure will be necessary to relocate the catheter (8). Late leaks frequently result in replacement of the peritoneal catheter (12).…”

Section: Discussionmentioning

confidence: 99%

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Minilaparoscopic Extraperitoneal Tunneling with Omentopexy: A New Technique for CAPD Catheter Placement

Öğünç

2005

Perit Dial Int

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Background Continuous ambulatory peritoneal dialysis (CAPD) is an effective form of treatment for patients with end-stage renal disease. Open insertion of peritoneal dialysis (PD) catheters is the standard surgical technique, but it is associated with a relatively high incidence of catheter-related problems. To overcome these problems, different laparoscopic techniques have been presented, being preferable to the open and percutaneous methods. Objective To introduce and evaluate the efficiency of laparoscopic omental fixation and extraperitoneal placement of the cuff–coil part (the straight portion) of the catheter to prevent catheter tip migration, pericatheter leakage, severe abdominal pain, and the obstruction caused by omental wrapping. Setting The study was carried out in the General Surgery Department, Akdeniz University Medical School, in Turkey. Patients and Methods Between November 2001 and March 2005, the technique was applied in 44 consecutive patients (mean age 51.6 years, range 18 – 67 years) with end-stage renal disease. During this laparoscopic technique, the omentum was first fixed onto the parietal peritoneum, and then the catheter was introduced through the subumbilical trocar site into the posterior rectus compartment and advanced toward the symphysis pubis. The catheter was then inserted into the abdominal cavity, passing the peritoneal opening, which was prepared before catheter insertion. The straight portion of the catheter was located into the extraperitoneal area of the anterior abdominal wall. The curled end, which contains the side-holes of the catheter, was placed into the true pelvis. Catheter position and patency were verified under direct vision using a 2 mm telescope. Results All procedures were completed laparoscopically. Operating time ranged between 40 and 100 minutes (median 52 minutes). There was no intraoperative complication or surgical mortality. Peritoneal dialysis was initiated within 15 – 24 hours after catheter implantation. After a median follow-up period of 17.4 months (range 1 – 38 months), early exit-site infection occurred in 1 of 44 patients. All catheters functioned well postoperatively. There was no pain during CAPD. Conclusion This new laparoscopic technique using an extraperitoneal approach with omentopexy for PD catheter placement could prove extremely useful for preventing catheter malfunction caused by catheter tip migration, pericatheter leakage, omental wrapping, and periodic catheter movement that causes abdominal pain in CAPD.

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Section: Discussionmentioning

confidence: 99%

“…Catheter tip migration still accounts for a substantial number of catheter failures in both openly and laparoscopically placed CAPD catheters. The frequency of migration is 22% – 54% (8). Surgical rescue is required in 85% – 90% of these cases (6).…”

mentioning

confidence: 99%

Minilaparoscopic Extraperitoneal Tunneling with Omentopexy: A New Technique for CAPD Catheter Placement

Öğünç

2005

Perit Dial Int

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“…Catheter outflow failure follows open surgical and blind guidewire/trocar methods in 10% – 34.5% of placements (2,17,33,47,48), whereas laparoscopic placement techniques are complicated by flow dysfunction in 4% – 13% of patients (33,49). Unfortunately, outflow obstruction is a complication found in up to 60% of patients in some investigative series (2,5,22,33,50-53), increasing the cost of dialysis and possibly causing other problems, such as the need for temporary HD and intraperitoneal adhesion formation due to repeated surgery. Up to 20% of patient transfers to HD are directly related to catheter problems (26).…”

Section: Discussionmentioning

confidence: 99%

“…Up to 20% of patient transfers to HD are directly related to catheter problems (26). Change in body position, rapid saline infusion, cathartics, enemas, the classic use of fibrinolytics, and fluoroscopic manipulation are conservative measures often used in attempting to restore drainage in patients with poorly functioning catheters (1,7,53).…”

Section: Discussionmentioning

confidence: 99%

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Malfunctioning Peritoneal Dialysis Catheter and Accompanying Surgical Pathology Repaired by Laparoscopic Surgery

Öğünç

2002

Perit Dial Int

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♦ Objectives To review the laparoscopic salvaging of malfunctioning peritoneal dialysis (PD) catheters, and to present our experience with laparoscopic repair of dysfunctional Tenckhoff catheters and the treatment of accompanying surgical pathologies. ♦ Design Malfunctioning peritoneal catheters were repaired using laparoscopic rescue techniques. Accompanying surgical problems were treated in the same operation. The effectiveness of these approaches was validated by comparison with other remedial techniques described previously. ♦ Patients Malfunctioning PD catheters were salvaged by laparoscopic surgery in 8 patients, and accompanying surgical problems were treated in the same operation in 3 of the 8 patients. ♦ Main Outcome Measures Outcome was measured by the successful return to adequate PD and effective treatment of surgical problems. ♦ Results Eight patient studies show laparoscopic correction of malfunctioning catheters and the treatment of accompanying surgical pathologies with the return to successful PD. ♦ Conclusion The salvaging of malfunctioning PD catheters by laparoscopic surgery is an ideal method. This procedure permits simultaneous identification and correction of other surgical problems that could otherwise complicate dialysis therapy.

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PD Catheter Placement and Early Use

London,

Sheta

2024

Principles of Dialysis Access

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Fluoroscopic Manipulation is also useful for Malfunctioning Swan-Neck Peritoneal Catheters

Cited by 12 publications

References 9 publications

Minilaparoscopic Extraperitoneal Tunneling with Omentopexy: A New Technique for CAPD Catheter Placement

Minilaparoscopic Extraperitoneal Tunneling with Omentopexy: A New Technique for CAPD Catheter Placement

Malfunctioning Peritoneal Dialysis Catheter and Accompanying Surgical Pathology Repaired by Laparoscopic Surgery

PD Catheter Placement and Early Use

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