Laparoscopy and the Management of Peritoneal Dialysis Complications

• Published in: Journal of pediatric urology 2008, Vol.4, p.S79-S79
• Main Author: Rene Hilaire PRISO, Rony SFEIR , Annie LAHOCHE , Estelle AUBRY , Khalid MOOSA , Remi BESSON
• Format: Article
• Language: English
• Subjects: Pediatrics; Urology
• ISSN: 1477-5131; 1873-4898
• DOI: 10.1016/j.jpurol.2008.01.116

Abstract PURPOSE Continuous ambulatory peritoneal dialysis (CAPD) has become very effective and suits kids and parents in their daily life.Two major complications may occur, peritonitis and catheter impairement. The latter requires surgery. Laparoscopy may be a useful tool in the management of CAPD complications. MATERIAL AND METHODS From 2000 to 2006, 40 children (range 6months - 15 years) were included in the CAPD project. We reviewed all the records concerning catheter failure of drainage treated by laparoscopy. RESULTS 3 cases (7,5%) of catheter non-function, twice a 13 years old girl and once a 12 year old boy. A catheter flow obstruction occured a week after starting CAPD. Laparoscopy (3 port sites, 5, 5 and 10 mm) showed the great omentum wrapped around the catheter. It was unwrapped by laparoscopy. A week latter, a new laparoscopy was performed for the same cause. We decided to perform a partial omental resection. The boy had his catheter impairement a month after he started CAPD. By laparoscopy, we unwrapped the epiploon and partially resected it. No recurrence since then. Laparoscopy permits to identify the problem and to solve it by unwrapping and removing part of the omentum to free the in and outflow holes of the catheter. CONCLUSIONS Laparoscopy in the management of CAPD failure of drainage is useful. We advocate a laparoscopic partial omentectomy in cases of catheter wrapping.