A Standardized Technique of Laparoscopic Placement of Peritoneal Dialysis Catheter with Omentectomy and Closure of Patent Processus Vaginalis: A 3-in-1 Minimally Invasive Surgical Approach in Children
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In brief
In brief
This retrospective study demonstrates a standardized laparoscopic three-in-one technique for PD catheter placement in children that combines omentectomy and PPV closure, significantly reducing catheter failure rates compared to open surgery. The lap3-in-1 approach eliminated reoperations for omental wrapping and inguinal hernias while achieving superior catheter survival outcomes.
Written by the GCMD Library team from the article.
Background
Omental wrapping is a common cause for catheter failure in children on peritoneal dialysis (PD). Previous studies are conflicting in the benefits of omentectomy.
Methods
We conducted a retrospective study comparing children who underwent PD catheter placement by a standardized laparoscopic three-in-one technique (lap3-in-1) from 2013 to 2018 versus a historical control cohort by open surgery without omentectomy. Lap3-in-1technique combined catheter placement with well-defined indication and extent of omentectomy, and closure of any patent processus vaginalis (PPV).
Results
There were 33 and 32 children in the lap3-in-1 and control cohorts respectively. 4/33(12.1%) in lap3-in-1 had reoperations for catheter failures which equated 1 reoperation per 144 catheter months. No reoperations were performed in lap3-in-1 cohort for omental wrapping or inguinal hernia, compared with 13/32 (41%; p