Guidelines for laparoscopic peritoneal dialysis access surgery

The placement of percutaneous peritoneal dialysis catheters under direct peritoneoscopic visualization is a relatively new technique for establishing peritoneal dialysis access. In this study, in which a modification of the Seldinger technique was used to facilitate the placement of the peritoneoscope, the experience with 82 consecutive catheterization procedures in 78 patients is reported. In 2 (2.4%) of 82 catheterization procedures, we were unable to enter the peritoneal cavity but experienced no other complications unique to the percutaneous approach. Of the 80 successful catheterization procedures, 76 represented first-time catheter placement and constituted a population subjected to life-table analysis examining catheter survival rates, the time to first cutaneous exit site or s.c. tunnel infection, and the time to first episode of peritonitis. After a follow-up period of 50.1 patient yr, 11 catheters were lost because of catheter dysfunction. Other clinical complications included peritoneal fluid leaks at the cutaneous exit site in 11 instances (0.22/patient yr), cutaneous exit site infection in 7 instances (0.14/patient yr), s.c. tunnel infection in 2 instances (0.04/patient yr), and 34 episodes of peritonitis (0.68/patient yr). The results of this study demonstrate that the suggested modification of the percutaneous placement of peritoneal dialysis catheters, under peritoneoscopic visualization, is a viable method for establishing peritoneal access.

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Dialysis Access Surgery

Therapy of Renal Diseases and Related Disorders ◽

10.1007/978-1-4613-0689-4_51 ◽

1991 ◽

pp. 775-789

Author(s):

George P. Noon ◽

H. David Short

Keyword(s):

Dialysis Access ◽

Access Surgery

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Team Training to Establish a Safety Culture in Dialysis Access Surgery

Contributions to Nephrology - Patient Safety in Dialysis Access ◽

10.1159/000365826 ◽

2015 ◽

pp. 97-106 ◽

Cited By ~ 2

Author(s):

Ingemar Davidson ◽

Matthias K. Widmer ◽

Billy Nolen ◽

John Ross ◽

Douglas P. Slakey

Keyword(s):

Safety Culture ◽

Team Training ◽

Dialysis Access ◽

Access Surgery

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Peritoneal dialysis access in children

Pediatric Dialysis ◽

10.1007/978-94-007-1031-3_6 ◽

2004 ◽

pp. 83-89 ◽

Cited By ~ 4

Author(s):

M. L. Brandt ◽

E. D. Brewer

Keyword(s):

Peritoneal Dialysis ◽

Dialysis Access

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Peritoneal Dialysis Access

Comprehensive Pediatric Nephrology ◽

10.1016/b978-0-323-04883-5.50060-x ◽

2008 ◽

pp. 823-834 ◽

Cited By ~ 1

Author(s):

Bradley A. Warady ◽

Walter S. Andrews

Keyword(s):

Peritoneal Dialysis ◽

Dialysis Access

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A Laparoscopic Method for Optimal Peritoneal Dialysis Access

The American Surgeon ◽

10.1177/000313480507100209 ◽

2005 ◽

Vol 71 (2) ◽

pp. 135-143 ◽

Cited By ~ 34

Author(s):

John H. Crabtree ◽

Arnold Fishman

Keyword(s):

Peritoneal Dialysis ◽

Financial Incentives ◽

Rectus Sheath ◽

Laparoscopic Approach ◽

Dialysis Access ◽

Medical Benefits ◽

Implantation Techniques ◽

Procedural Complications ◽

Modality Variable

Both medical benefits to the patient and financial incentives to the health care system exist to increase the use of peritoneal dialysis as renal replacement therapy. Providing long-term peritoneal access free of mechanical dysfunction continues to represent a major challenge to the success of this modality. Variable outcomes result from the lack of standard implantation methodology and failure to address persistent problems associated with current implantation techniques. This prospective case study compared noninfectious procedural complications of three approaches to establish peritoneal dialysis access. The groups consisted of 63 catheters implanted by traditional open dissection, 78 catheters implanted by basic laparoscopy without associated interventions, and 200 catheters implanted by advanced laparoscopic methods including rectus sheath tunneling, selective prophylactic omentopexy, and selective adhesiolysis. Mechanical flow obstruction, the major outcome indicator, followed only 1 of 200 (0.5%) implantation procedures in the advanced group and was significantly better ( P < 0.0001) than the open dissection (17.5%) and basic laparoscopic (12.5%) groups. A low rate of pericannular leaks (1.3–2%) was not different for the three groups. One pericannular hernia occurred in the open group. Catheter mechanical dysfunction attributable to the surgical technique can nearly be eliminated through adjunctive procedures made possible only by a laparoscopic approach.

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Fifty years of hemodialysis access literature: The fifty most cited publications in the medical literature

Vascular ◽

10.1177/1708538117721001 ◽

2017 ◽

Vol 26 (1) ◽

pp. 75-79

Author(s):

Edvard Skripochnik ◽

David J O’Connor ◽

Eric B Trestman ◽

Evan C Lipsitz ◽

Larry A Scher

Keyword(s):

Medical Literature ◽

Chronic Hemodialysis ◽

Dialysis Access ◽

Hemodialysis Access ◽

Av Fistula ◽

Hemodialysis Catheter ◽

Number Of Patients ◽

Number Of Publications ◽

Modern Era ◽

Access Surgery

Objectives The modern era of hemodialysis access surgery began with the publication in 1966 by Brescia et al. describing the use of a surgically created arteriovenous fistula. Since then, the number of patients on chronic hemodialysis and the number of publications dealing with hemodialysis access have steadily increased. We have chronicled the increase in publications in the medical literature dealing with hemodialysis access by evaluating the characteristics of the 50 most cited articles. Methods We queried the Science Citation Index from the years 1960–2014. Articles were selected based on a subject search and were ranked according to the number of times they were cited in the medical literature. Results The 50 most frequently cited articles were selected for further analysis and the number of annual publications was tracked. The landmark publication by Dr Brescia et al. was unequivocally the most cited article dealing with hemodialysis access (1109 citations). The subject matter of the papers included AV fistula and graft (9), hemodialysis catheter (9), complications and outcomes (24), and other topics (8). Most articles were published in nephrology journals (33), with fewer in surgery (7), medicine (7), and radiology (3) journals. Of the 17 journals represented, Kidney International was the clear leader, publishing 18 articles. There has been an exponential rise in the frequency of publications regarding dialysis access with 42 of 50 analyzed papers being authored after 1990. Conclusion As the number of patients on hemodialysis has increased dramatically over the past five decades, there has been a commensurate increase in the overall number of publications related to hemodialysis access

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Peritoneal dialysis catheter insertion surgery and management

The Journal of Vascular Access ◽

10.1177/1129729818762989 ◽

2018 ◽

Vol 20 (1_suppl) ◽

pp. 97-99

Author(s):

Kazunari Yoshida ◽

Daisuke Ishii

Keyword(s):

Peritoneal Dialysis ◽

Invasive Surgery ◽

Catheter Insertion ◽

Peritoneal Dialysis Catheter ◽

Dialysis Catheter ◽

Less Invasive Surgery ◽

Exit Site ◽

Less Invasive ◽

Access Surgery ◽

Dialysis Discontinuation

Peritoneal access surgery is the first step to achieve successful peritoneal dialysis. It is important to perform easy, safe, and less invasive surgery of peritoneal dialysis catheter insertion. Secure peritoneal dialysis catheter insertion will lead to less infection, that is, exit site, tunnel infection, and peritonitis, which sometimes result in peritoneal dialysis discontinuation. To avoid these undesirable results, we should perform good and proper peritoneal dialysis insertion surgery. In this article, we describe peritoneal dialysis catheter insertion surgery and its management.

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