Laparoscopic-Assisted Seldinger Technique for Peritoneal Dialysis Catheter Insertion.

Abstract

The management of kidney failure has advanced considerably, with peritoneal dialysis (PD) established as a reliable treatment option that uses the peritoneal membrane to remove excess fluid and toxins. PD has shown particular benefits in the initial stages of treatment, potentially leading to better outcomes compared to hemodialysis. Successful PD, however, depends heavily on the correct placement of the PD catheter. This study presents a protocol to perform the laparoscopic-assisted Seldinger technique (LAST) for peritoneal dialysis catheter insertion, highlighting a combination of the Seldinger method's minimal invasiveness with the enhanced visualization of laparoscopy. LAST allows precise catheter placement, making it especially suitable for patients with prior abdominal surgery or those requiring urgent-start PD. This technique enables patients to initiate PD within a day of catheter insertion. The post-surgical protocol involves a gradual increase in dialysate volume, allowing patients to achieve a full PD dose by day five while maintaining controlled peritoneal pressure and minimizing the risk of dialysate leaks. By integrating laparoscopic visualization with the minimally invasive Seldinger technique, LAST has the potential to offer a superior alternative to traditional methods.