Peritoneal Dialysis Catheter Placement in Children: Initial Experience with a “2+1”-Port Laparoscopic-Assisted Technique

Abstract

The placement of a peritoneal dialysis catheter (PDC) is currently a common procedure in pediatric surgeon practice, and the search for the ultimate technique never stops. The purpose of this study is to evaluate our experience with the laparoscopic PDC placement approach, performing a “2+1” (“two plus one”) technique, where the “+1” trocar is placed in an oblique manner, pointing toward the Douglas pouch when passing through the abdominal wall. This tunnel is further used to place and maintain the proper position of the PDC. Materials and methods: We assessed a cohort of five children who underwent laparoscopic-assisted PDC placement between 2018 and 2022. Results: This procedure is a simple, relatively quick, and safe technique for PDC placement. Furthermore, in our experience, concomitant omentectomy is necessary to reduce the risk of catheter obstruction and migration due to omental wrapping. Conclusions: The laparoscopic approach allows for improved visualization and more accurate placement of a catheter inside the abdominal cavity. Concomitant omental excision is necessary to prevent PDC malfunction and migration.