Peritoneoscopic insertion of peritoneal dialysis catheters by nephrologists. A single centre preliminary experience

Hippokratia 2011; 15 (Suppl 2): 27-29

E. Fourtounas, P. Dousdampanis, A. Hardalias, K. Trigka, JG Vlachojannis


Background: Peritoneal Dialysis (PD) catheter has been characterized as the “lifeline” of PD patients. Timely and effective insertion of the PD catheter is essential for the success of a PD program. We describe our initial experience with peritoneoscopic implantation of PD catheters by nephrologists. Patients and Methods: Twenty-one patients underwent peritoneoscopic PD catheter implantation in our centre during 2007 – 2009. Their mean age was 57.3±14.7 years, 8 patients (38%) were transferred from hemodialysis and 12 patients (57%) had a previous history of uncomplicated abdominal surgery for various reasons.
Results: All PD catheters were inserted under local anaesthesia in a nephrology ward. There were no major complications during, or immediately after catheter implantation. There were 4 cases of eosinophilic peritonitis following air entrapment in the peritoneal cavity. PD fluid leak was observed in two cases and an abdominal hernia in one case. The PD catheter did not work properly in 3 cases and in two of them the catheter was removed and replaced by a new one by surgeons. During the follow up period a total of 5 catheters were removed: three of them after successful renal transplantation and two due to poor functioning.
Conclusions: PD catheter insertion by nephrologists with peritoneoscopy is a rather simple, safe and efficient method. It offers the opportunity for timely initiation of PD and a relative independence from surgeons, reducing the waiting times and therefore enhancing PD uptake.