Published online Oct 27, 2013. doi: 10.4240/wjgs.v5.i10.268
Revised: September 15, 2013
Accepted: October 16, 2013
Published online: October 27, 2013
A 40-year-old male underwent tube placement surgery for continuous ambulatory peritoneal dialysis (CAPD). A 2-cm skin incision was made, and the peritoneum was reflected enough to perform secure fixation. A swan-necked, double-felted silicone CAPD catheter was inserted, and the felt cuff was sutured to the peritoneum to avoid postoperative leakage. An adequate gradient for tube fixation to the abdominal wall was confirmed. The CAPD tube was passed through a subcutaneous tunnel. Aeroperitoneum was induced to confirm that there was no air leakage from the sites of CAPD insertion. Two trocars were placed, and we confirmed that the CAPD tube led to the rectovesical pouch. Tip position was reliably observed laparoscopically. Optimal patency of the CAPD tube was confirmed during surgery. Placement of CAPD catheters by laparoscopic-assisted surgery has clear advantages in simplicity, safety, flexibility, and certainty. Laparoscopic technique should be considered the first choice for CAPD tube insertion.
Core tip: Continuous ambulatory peritoneal dialysis (CAPD) is currently considered the preferred choice for dialytic treatment, based on 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. Here, we present our surgical procedures and discuss key techniques and pitfalls with literature review.