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Laparoscopic fixation of a malfunctioning Tenckhoff catheter using the PIRS method — presentation of two cases
open access
Abstract
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.
Abstract
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.
Keywords
peritoneal dialysis, Tenckhoff catheter malfunction, children, laparoscopy
About this articleTitle
Laparoscopic fixation of a malfunctioning Tenckhoff catheter using the PIRS method — presentation of two cases
Journal
Chirurgia Polska (Polish Surgery)
Issue
Pages
75-82
Published online
2016-06-30
Page views
747
Article views/downloads
926
Bibliographic record
Chirurgia Polska 2015;17(1-2):75-82.
Keywords
peritoneal dialysis
Tenckhoff catheter malfunction
children
laparoscopy
Authors
Katarzyna Zachwieja
Dariusz Chmiel
Bartosz Bogusz
Monika Miklaszewska
Maria Dzierżęga
Dorota Drożdż
Jacek A. Pietrzyk
