Laparoscopic Tenckhoff catheter insertion using an improvised pre-peritoneal tunneling technique under conscious sedation – 1 year outcome

Abstract

Background: Peritoneal dialysis (PD) catheter dysfunction is one of the reasons for PD dropout. Tenckhoff Catheter (TC) functional longevity will improve PD outcomes. This series aims to study the safety and feasibility of laparoscopic TC insertion using an improvised pre-peritoneal tunneling technique under conscious sedation. 

Methods: Retrospective observational study of patients who underwent laparoscopic TC insertions using the proposed improvised preperitoneal tunneling technique under conscious sedation.

Results: The mean age of the patients was 51.10 (SD=13.43) years old. Patients’ mean body mass index was 25.44 (SD=4.27) kg/m². The procedure was performed on 115 patients, 78 (67.8%) had previous abdominal surgery. 15 (13.0%) required catheter reinsertion using this technique due to non-functioning existing TC inserted via a different method. 3 (2.6%) of the patients developed primary catheter dysfunction. At one-year post procedure the catheter survival rate was 97.3%, with a patient survival rate of 87.0%. At the time of writing, median catheter survival was 16.5 months.

Conclusion: Laparoscopic TC insertion using this pre-peritoneal tunneling technique under conscious sedation is able to yield satisfactory catheter functionality, particularly for patients with a history of abdominal surgery, all while avoiding the risks associated with general anesthesia.