Akademik Veri Yönetim Sistemi
Pediatrik Cerrahi Dergisi, cilt.14, sa.1, ss.20-24, 2000 (Scopus, TRDizin)
Since 1996, peritoneal dialysis catheter placement procedures have been carried on laparoscopically in 12 male and 12 female patients with renal failure. The patients ages range between 19 months and 16 years(mean age: 9.1 year). Needlescope was used in the first 3 patients while in the remaining, a 5 or 10 mm telescope was used through umbilical trocar. Then depending on the patient's size, a 5 or 10 mm second trocar is introduced into the abdominal cavity after creating a 4-5 cm subcutaneous tunnel. The Tenckhoff catheter is inserted into the abdominal cavity through the same subcutaneous tunnel and the tip of the catheter could easily be placed into the Douglas pouch under the laparoscopic vision. The major complications such as peritonitis and outflow obstruction are evaluated retrospectively. During the 13,7 month follow-up period, peritonitis developed in 6 patients and were treated medically in all. Secondary procedures were needed to be performed because of catheter dislodgment and outflow problems in 6 patients. 4 of them were carried on with laparotomy including omentectomy while in the last one the tip of the catheter was placed into the correct position with laparoscopy. In this patient, omentectomy through the umbilical trocar incision was also performed. A dislocated catheter tip was redirected into pelvic region under fluoroscopy. Strangulated incisional hernia developed in a patient after the revision of the catheter with the open surgical technique. Same patient, ultimately died because of nasopharyngeal malignancy that caused incredible bleeding. Laparoscopy is a safe method in both insertion and salvaging of the peritoneal dialysis catheters as it has the advantage of correct placement of the catheter under direct vision in children.