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Vol 17, No 1-2 (2015)
Case reports
Published online: 2016-06-30

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Laparoscopic fixation of a malfunctioning Tenckhoff catheter using the PIRS method — presentation of two cases

Katarzyna Zachwieja, Dariusz Chmiel, Bartosz Bogusz, Monika Miklaszewska, Maria Dzierżęga, Dorota Drożdż, Jacek A. Pietrzyk
Chirurgia Polska 2015;17(1-2):75-82.


Malfunction of a peritoneal catheter is among the most common complications of peritoneal dialysis in children. The paper presents a novel laparoscopic method — PIRS (percutaneous internal ring suturing) — with the catheter being fixed to the anterior abdominal wall in two cases of malfunctioning peritoneal catheters. One patient presented with an untypical displacement of the catheter tip with its holes partially occluded by the greater omentum. Following the initial classic surgical revision, only a short-term improvement was achieved. In the second patient, dialyzate outflow was stopped, but no catheter tip displacement was observed. Intraoperatively, the catheter was found to be embedded in a peritoneal pocket, what rendered its normal functioning impossible. The catheter tip required repositioning and placement in the proper location above the right iliac ala. A novel laparoscopic method was employed in both patients, with a single port being used in the first patient. Subsequently, peritoneal dialysis was successfully continued in both children.

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