CLINICAL PROFILE AND OUTCOME OF LAPAROSCOPIC ASSISTED CAPD CATHETER INSERTION - A SINGLE CENTRE EXPERIENCE

Introduction:

Continuous ambulatory peritoneal dialysis (CAPD) is considered the preferred modality for dialytic therapy, on the basis of improved quality of life and patient survival. The open surgical technique for tube placement is easy, though a painful large incision is needed and unexpected tube dislocation may occur. Minimally invasive technique and optimal tube position should be guaranteed in the placement of CAPD catheters. We suggested that placement of CAPD catheters by laparoscopic-assisted surgery has clear advantages in simplicity, safety, flexibility, and certainty. 

We report the experience of laparoscopic assisted CAPD catheter insertion for End stage renal disease patients and successful break in period being achieved.

Methods:

This is a retrospective observational study done at RGGGH, Chennai at Institute of Nephrology from August 2023 to July 2024 of End stage renal disease patients who underwent laparoscopic assisted CAPD catheter insertion by review of medical records

Results:

A total of 13 patients were planned and assessed for laparoscopic assisted CAPD catheter insertion of which 12 patients underwent successful procedure. The remaining one patient with prior history of CAPD peritonitis, the procedure was abandoned due to thick adhesions and loculated septations on intraop finding. Among the 12 patients, median age being 48 years, Males being 58.3%, 3 patients underwent laparoscopic insertion as primary modality, 2 patients due to failure of attempted open technique, 7 patients due to AV fistula access issues. Among the 12 patients, 3 patients had prior history of CAPD catheter insertion via open technique and removed due to peritonitis and were reinitiated later via laparoscopic method. 2 patients had complications within the break in period. One patient had immediate complication in the form of pericatheter leak on day 1 while starting Urgent start CAPD while one patient had outflow issues on day 9 necessitating lap assisted adhesiolysis.

Conclusions:

Laparoscopic assisted CAPD surgeries result in less pain, shortened convalescence, improved cosmesis, and absence of wound complications. Laparoscopic approach is a very useful tool in the induction of PD programs.

I have no potential conflict of interest to disclose.

I did not use generative AI and AI-assisted technologies in the writing process.