Kidney insufficiency

Abstract

General considerations In this condition the patients need either hemodialysis or peritoneal dialysis to treat terminal renal insufficiency In our experience catheter longevity is superior after laparoscopic implantation compared to open surgical implantation We describe the use of laparoscopy in the following situations • Primary laparoscopic implantation of a Tenckhoff catheter for peritoneal dialysis • Laparoscopy to reestablish continuous abdominal peritoneal dialysis (CAPD) in cases of a malfunctioning catheter • Secondary laparoscopic implantation of a peritoneal catheter because the original catheter has malfunctioned The cumulative probability of catheter malfunction with subsequent catheter replacement is, according to the National CAPD Registry of the National Institutes of Health (1988): • 18% after 12 months on CAPD • 32% after 24 months The cumulative probability of exit-site or tunnel infection is • 33% in the first year of CAPD • 49% in the second year © 2009 Springer-Verlag.