Clinical application of simplified laparoscopic subcutaneous tunneled technique for peritoneal dialysis catheter placement.

BACKGROUND

This study aimed to evaluate the safety and efficacy of a simplified single-port laparoscopic rectus sheath tunneling technique for peritoneal dialysis (PD) catheter implantation compared with conventional laparoscopic placement.

METHODS

We conducted a retrospective analysis of 70 patients who underwent PD catheter placement at our center between October 2019 and October 2024. Inclusion criteria were: Age > 18 years, BMI < 30 kg/m2, no prior major abdominal surgeries, and no significant abdominal adhesions on preoperative imaging. Patients were divided into two groups: The study group (n = 35) received single-port laparoscopic rectus sheath tunneled catheter placement, while the control group (n = 35) underwent conventional laparoscopic placement. All procedures were performed by the same surgical team. Comparative parameters included demographic characteristics, primary diseases, and postoperative outcomes.

RESULTS

The simplified technique demonstrated:100% technical success rate, Mean operative time of 39.8 ± 8.6 min (vs 48 ± 11.8 min in controls, P = 0.0014); Zero conversions to open surgery, Significantly reduced incidence of postoperative tunnel bleeding (8.6 vs 14.3%, P = 0.003); and lower rates of early pericatheter leakage, Shorter operative time compared to conventional methods (2.9 vs 8.6%, P = 0.018). Catheter migration occurred in 3 control patients (8.6%) versus none in the study group. Kaplan-Meier analysis showed 100% catheter survival at 12 months in both groups. And demonstrated superior catheter survival in the simplified technique group compared to conventional laparoscopic placement (log-rank P = 0.036).

CONCLUSION

In this single-center cohort, the simplified laparoscopic tunneled technique showed advantages including reduced operative time and lower complication rates compared to conventional methods. Larger multicenter studies are needed to validate these findings.