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Lyu S, He Y, Tao X, Yao Y, Huang X, Ma Y, Peng Z, Ding Y, Wang Y. Subcutaneous power supply by NIR-II light. Nat Commun 2022; 13:6596. [PMID: 36329024 PMCID: PMC9633840 DOI: 10.1038/s41467-022-34047-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 10/12/2022] [Indexed: 11/06/2022] Open
Abstract
Implantable medical devices are wished to be recharged via contactless power transfer technologies without interventional operations. Superior to subcutaneous power supply by visible light or electromagnetic wave, second near-infrared (NIR-II) light is predicted to possess 60 times subcutaneous power transmission but hard to be utilized. Here we report a photo-thermal-electric converter via the combination of photothermal conversion and thermoelectric conversion. It is able to generate an output power as high as 195 mW under the coverage of excised tissues, presenting advantages of non-invasion, high output power, negligible biological damage, and deep tissue penetration. As an in vivo demonstration, the output power of a packaged converter in the abdominal cavity of a rabbit reaches 20 mW under NIR-II light irradiation through the rabbit skin with a thickness of 8.5 mm. This value is high enough to recharge an implanted high-power-consumption wireless camera and transfer video signal out of body in real-time.
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Affiliation(s)
- Shanzhi Lyu
- grid.24539.390000 0004 0368 8103Key Laboratory of Advanced Light Conversion Materials and Biophotonics, Department of Chemistry, Renmin University of China, 100872 Beijing, China ,grid.12527.330000 0001 0662 3178Department of Energy and Power Engineering, Tsinghua University, 100082 Beijing, China
| | - Yonglin He
- grid.24539.390000 0004 0368 8103Key Laboratory of Advanced Light Conversion Materials and Biophotonics, Department of Chemistry, Renmin University of China, 100872 Beijing, China
| | - Xinglei Tao
- grid.24539.390000 0004 0368 8103Key Laboratory of Advanced Light Conversion Materials and Biophotonics, Department of Chemistry, Renmin University of China, 100872 Beijing, China
| | - Yuge Yao
- grid.12527.330000 0001 0662 3178Department of Energy and Power Engineering, Tsinghua University, 100082 Beijing, China
| | - Xiangyi Huang
- grid.24539.390000 0004 0368 8103Key Laboratory of Advanced Light Conversion Materials and Biophotonics, Department of Chemistry, Renmin University of China, 100872 Beijing, China
| | - Yingchao Ma
- grid.24539.390000 0004 0368 8103Key Laboratory of Advanced Light Conversion Materials and Biophotonics, Department of Chemistry, Renmin University of China, 100872 Beijing, China
| | - Zhimin Peng
- grid.12527.330000 0001 0662 3178Department of Energy and Power Engineering, Tsinghua University, 100082 Beijing, China
| | - Yanjun Ding
- grid.12527.330000 0001 0662 3178Department of Energy and Power Engineering, Tsinghua University, 100082 Beijing, China
| | - Yapei Wang
- grid.24539.390000 0004 0368 8103Key Laboratory of Advanced Light Conversion Materials and Biophotonics, Department of Chemistry, Renmin University of China, 100872 Beijing, China
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Pan A, Poi MJ, Matos J, Jiang JS, Kfoury E, Echeverria A, Bechara CF, Lin PH. Long-Term Outcomes of Single-Port Laparoscopic Placement of Peritoneal Dialysis Catheter. Vasc Endovascular Surg 2016; 50:343-8. [PMID: 27260751 DOI: 10.1177/1538574416652245] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Laparoscopic insertion of peritoneal dialysis (PD) catheter has become a preferred method compared to the traditional open technique for PD catheter insertion. We retrospectively report the outcome of 1-port laparoscopic placement PD catheters in our institution. METHODS A total of 263 patients with end-stage renal disease who underwent single-trocar laparoscopic PD catheter insertion during a recent 6-year period were reviewed. Laparoscopic technique involves introducing a PD catheter over a stiff guidewire into the abdominal cavity through a 10-mm laparoscopic port. Pertinent clinical variables, procedural complications, and follow-up outcome were analyzed. RESULTS There were 182 men and 81 women. The mean age was 56 years. Technical success was 95.8%. Catheter occlusion was the most common early complications (<6 months) that occurred in 4 (1.5%) patients. Late complications (> 6 months) including catheter occlusion, cuff extrusion, catheter leakage, catheter migration, infection, and hernia occurred in 5 patients (1.9%), 2 patients (0.8%), 3 patients (1.1%), 3 patients (1.1%), 6 patients (2.3%), and 4 patients (1.5), respectively. Mean follow-up time was 39 ± 18 months. Catheter survival rate at 1, 2, 3, 4, and 5 years was 96%, 94%, 90%, 85%, and 82%, respectively. CONCLUSION Laparoscopic PD catheter implantation via a single-trocar utilizing a stiff guidewire technique is feasible and safe. This method can result in low complication and high catheter survival rate.
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Affiliation(s)
- Alan Pan
- Division of Vascular Surgery & Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Mun J Poi
- Division of Vascular Surgery & Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Jesus Matos
- Division of Vascular Surgery & Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Jenny S Jiang
- Division of Vascular Surgery & Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Elias Kfoury
- Division of Vascular Surgery & Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Angela Echeverria
- Division of Vascular Surgery & Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Carlos F Bechara
- Department of Cardiothoracic and Vascular Surgery, Houston Methodist Hospital, Houston, TX, USA
| | - Peter H Lin
- Division of Vascular Surgery & Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
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Bıçakcı Ü, Genç G, Tander B, Günaydın M, Demirel D, Özkaya O, Rızalar R, Arıtürk E, Bernay F. Single port laparoscopic and open surgical accesses of chronic peritoneal dialysis in children: A single center experience over 12 years. J Minim Access Surg 2016; 12:162-6. [PMID: 27073310 PMCID: PMC4810951 DOI: 10.4103/0972-9941.147364] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION: The aim of this study was to evaluate patients with end stage renal failure (ESRD) who underwent chronic peritoneal dialysis (CPD). The clinical outcomes of laparoscopic and open placements of catheters were compared. MATERIALS AND METHODS: We reviewed 49 (18 male and 31 female) children with CPD according to age, sex, cause of ESRD, catheter insertion method, kt/V rate, complications, presence of peritonitis, catheter survival rate between January 2002 and February 2014. RESULTS: Thirty-three patients were with open placement and 16 patients were with laparoscopic placement. The rate of the peritonitis is significantly less in patients with laparoscopic access than open access (n = 4 vsn = 25) (P <0.01). Patients with peritonitis were younger than those who had no attack of peritonitis (10.95 ± 0.8 years vs 13.4 ± 0.85 years). According to the development of complications, significant difference has not been found between the open (n = 9) and laparoscopic (n = 3) approaches except the peritonitis. Catheter survival rate for the first year was 95%, and for five years was 87.5%. There was no difference between open and laparoscopic group according to catheter survival rate. The mean kt/V which indicates the effectiveness of peritoneal dialysis was mean 2.26 ± 0.08. No difference was found between laparoscopic and open methods according to kt/V. CONCLUSION: Laparoscopic placement of CPD results in lower peritonitis rate. Catheter survival rate was excellent in both groups. Single port laparoscopic access for CPD catheter insertion is an effective and safe method.
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Affiliation(s)
- Ünal Bıçakcı
- Department of Pediatric Surgery, Ondokuz Mayis University, 55139 Samsun, Turkey
| | - Gürkan Genç
- Department of Pediatric Nephrology, Ondokuz Mayis University, 55139 Samsun, Turkey
| | - Burak Tander
- Department of Pediatric Surgery, Ondokuz Mayis University, 55139 Samsun, Turkey
| | - Mithat Günaydın
- Department of Pediatric Surgery, Ondokuz Mayis University, 55139 Samsun, Turkey
| | - Dilek Demirel
- Department of Pediatric Surgery, Ondokuz Mayis University, 55139 Samsun, Turkey
| | - Ozan Özkaya
- Department of Pediatric Nephrology, Ondokuz Mayis University, 55139 Samsun, Turkey
| | - Rıza Rızalar
- Department of Pediatric Surgery, Ondokuz Mayis University, 55139 Samsun, Turkey
| | - Ender Arıtürk
- Department of Pediatric Surgery, Ondokuz Mayis University, 55139 Samsun, Turkey
| | - Ferit Bernay
- Department of Pediatric Surgery, Ondokuz Mayis University, 55139 Samsun, Turkey
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Qiao Q, Zhou L, Hu K, Xu D, Li L, Lu G. Laparoscopic versus traditional peritoneal dialysis catheter insertion: a meta analysis. Ren Fail 2016; 38:838-48. [DOI: 10.3109/0886022x.2015.1077313] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
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The Survival and Complication Rates of Laparoscopic Versus Open Catheter Placement in Peritoneal Dialysis Patients. Surg Laparosc Endosc Percutan Tech 2015; 25:440-3. [DOI: 10.1097/sle.0000000000000188] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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6
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Guidelines for laparoscopic peritoneal dialysis access surgery. Surg Endosc 2014; 28:3016-45. [DOI: 10.1007/s00464-014-3851-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Accepted: 08/08/2014] [Indexed: 10/24/2022]
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Jiang C, Xu L, Chen Y, Yan X, Sun C, Zhang M. A modified open surgery technique for peritoneal dialysis catheter placement decreases catheter malfunction. Perit Dial Int 2014; 34:358-67. [PMID: 24991051 DOI: 10.3747/pdi.2011.00298] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND This retrospective study was conducted to evaluate the effect of a new, modified open surgery technique on catheter-related malfunction. METHODS During the period from January 1997 to June 2009, 216 patients received initial peritoneal catheters. For the present study, patients were divided into four groups according to the catheter types and the surgery techniques: TO-S: traditional open surgery, straight Tenckhoff catheter TO-C: traditional open surgery, coiled Tenckhoff catheter TO-SN: traditional open surgery, swan-neck catheter MO-S: modified open surgery, straight Tenckhoff catheter The modified surgery was characterized by a low incision site, a short intra-abdominal catheter segment and an additional upward straight subcutaneous tunnel. All patients were followed up for 2 years or until death. Survival rates, complications caused by catheter placement, and the probability of malfunction-free catheter survival were compared between the groups. RESULTS Catheter malfunction was the most frequent mechanical complication, found in 31 patients (14.4%), who experienced 38 malfunctions. Only 2 episodes of catheter malfunction were found in the MO-S group, representing a rate significantly less than those in the TO-S and TO-C groups (both p < 0.05). Kaplan-Meier curves for malfunction-free PD catheter survival showed a significantly different malfunction-free probability for the various groups (p = 0.009). After 2 years of follow-up, 136 patients (63.0%) survived with their initial PD catheter. The initial catheter survival rate was 76.8% in the MO-S group. Kaplan-Meier curves for initial catheter survival showed that the highest survival rate was found in the MO-S group (p = 0.001). CONCLUSIONS The modified open surgery technique is a reliable method for catheter placement.
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Affiliation(s)
- Chunming Jiang
- Department of Nephrology, and Department of Urology, Affiliated Drum Tower Hospital, Nanjing University, Nanjing, PR China
| | - Linfeng Xu
- Department of Nephrology, and Department of Urology, Affiliated Drum Tower Hospital, Nanjing University, Nanjing, PR China
| | - Yun Chen
- Department of Nephrology, and Department of Urology, Affiliated Drum Tower Hospital, Nanjing University, Nanjing, PR China
| | - Xiang Yan
- Department of Nephrology, and Department of Urology, Affiliated Drum Tower Hospital, Nanjing University, Nanjing, PR China
| | - Cheng Sun
- Department of Nephrology, and Department of Urology, Affiliated Drum Tower Hospital, Nanjing University, Nanjing, PR China
| | - Miao Zhang
- Department of Nephrology, and Department of Urology, Affiliated Drum Tower Hospital, Nanjing University, Nanjing, PR China
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A novel adaptation of laparoscopic Tenckhoff catheter insertion technique to enhance catheter stability and function in automated peritoneal dialysis. Langenbecks Arch Surg 2013; 399:525-32. [PMID: 24317438 DOI: 10.1007/s00423-013-1147-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Accepted: 11/15/2013] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Automated peritoneal dialysis (APD) normally takes place overnight. Maintaining a stable PD catheter position, independent of body position, omental wrapping or catheter displacement secondary to bowel movements is essential in maintaining effective catheter function. METHODS We developed a new procedure of catheter placement through combining and adapting several previously described operative techniques including laparoscopic placement of a curled double cuff Tenckhoff catheter with subcutaneous tunneling superior to the rectus sheet, an oblique course through the abdominal wall, deep entry into the pelvic peritoneum and directed placement of the curled tip within the pouch of Douglas. Retrospective analysis of catheter function was conducted, evaluating catheter position, function, complication rate and catheter survival against findings for current insertion techniques described within literature. RESULTS Between March 2009 and November 2011, 54 patients underwent PD catheter insertion. The observation period was an average of 343 ± 273 days. All patients received abdominal plain film showing optimal catheter position in 89 %. Reported catheter function was very good in 85.2 %, with no or few alarms per week during APD, moderate in 9.3 % with occasional minor dysfunctions (≤ 2 alarms per night), and poor in 5.6 %, with regular alarm disturbance. In one case, primary dysfunction led to catheter replacement. At completion, stable catheter function with occasional minor dysfunction was achieved in 52 of 54 cases. Catheter-related complications (leakage, hydrocele formation, infection and need for replacement) were observed in 14.8 %. At the end of the observation period, 55.6 % of catheters remained in use. Patient dropout occurred through death (18.5 %), renal transplantation (7.4 %), renal recovery (1.9 %), removal secondary to infection or dysfunction (9.3 %) and conversion to HD due to poor dialysis quality (7.4 %). CONCLUSION The above technique combines and optimises previously described laparoscopic catheter implantation techniques, allowing increased catheter stability resulting in an undisturbed catheter function suitable for APD.
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Kao CY, Chuang JH, Lee SY. A new simplified one-port laparoscopic technique for peritoneal dialysis catheter placement. Perit Dial Int 2013; 34:109-13. [PMID: 24084839 DOI: 10.3747/pdi.2012.00130] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
UNLABELLED BACKGROUND Various techniques for laparoscopic insertion of a peritoneal dialysis catheter have been described. Usually 2 - 3 ports are required, and complications related to the port sites (such as abdominal wall hernia, leakage, and hemorrhage) cannot be avoided. To minimize the potential complications, we designed a simplified 1-port laparoscopic technique for peritoneal dialysis catheter placement. ♢ METHODS We conducted a retrospective data review of 44 patients who underwent 1-port laparoscopic insertion of a Tenckhoff catheter from June 2009 to February 2011. All patient data, including postoperative complications, were analyzed. ♢ RESULTS The mean follow-up period was 11.52 months. All catheters were working properly, except in 1 patient who developed peritonitis 3 months after catheter placement. (The catheter was removed.) No postoperative abdominal wall hemorrhage, early leaks, hernias, or catheter migration occurred. No exit-site or tunnel infections were observed. ♢ CONCLUSIONS Our 1-port laparoscopic technique provides excellent catheter fixation, avoids excessive port sites, and yields good cosmesis. The low complication rate and the simplicity of the method justify its standard use for Tenckhoff catheter placement.
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Affiliation(s)
- Chun-Yu Kao
- Department of Pediatric Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
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10
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Bae IE, Chung WK, Choi ST, Kang J. Laparoscopic internal fixation is a viable alternative option for continuous ambulatory peritoneal dialysis catheter insertion. JOURNAL OF THE KOREAN SURGICAL SOCIETY 2012; 83:381-7. [PMID: 23230557 PMCID: PMC3514481 DOI: 10.4174/jkss.2012.83.6.381] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2011] [Revised: 09/09/2012] [Accepted: 09/22/2012] [Indexed: 12/14/2022]
Abstract
Purpose One of the major drawbacks of peritoneal dialysis (PD) is catheter migration and dysfunction. Preventing catheter migration is one of the main concerns. We compared laparoscopic internal fixation method with open surgical method for catheter migration rates. Methods From January 2008 to August 2009, PD catheters were inserted by laparoscopic fixation (LF) method in 22 patients and by open surgery (OS) in 32 patients. Clinical data were reviewed retrospectively. The frequency of migration, peritonitis, and other complications were compared. Catheter and patient survival rates were also compared. Results The mean age and sex ratio were not different between groups. Mean follow-up duration was 29.1 months in LF group and 26.1 months in OS group. More patients in LF group (27.3%) had history of laparotomy than in OS group (3.1%) (P = 0.01). The mean operation time was significantly longer in LF group (101.6 ± 30.4 minutes) than in OS group (72.4 ± 26.03 minutes) (P = 0.00). The cumulative incidence of catheter migration was 65.6% in OS group and 13.6% in LF group (P = 0.00). Migration-free catheter survival was higher in LF group (P = 0.001). There were no differences in complication rates between groups. Overall catheter survival was similar (P = 0.93). Patient survival rate at 2 years was not different (P = 0.13). Conclusion Laparoscopic internal fixation of continuous ambulatory peritoneal dialysis catheter significantly reduces migration rates without any addition of complications. Also, laparoscopic technique did not incur patient morbidity or mortality despite the requirement for general endotracheal anesthesia and longer operation time. Therefore, internal fixation can be afforded safely in patients with previous abdominal surgery as either a salvage or preventive measure in patients with repeated catheter migration.
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Affiliation(s)
- In Eui Bae
- Department of Surgery, Gachon University Gil Medical Center, Gachon University of Medicine and Science, Inchon, Korea
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11
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Gultekin FA, Cakmak GK, Karakaya K, Emre AU, Tascilar O, Oner MO, Comert M, Kulah E. Our long-term results of Tenckhoff peritoneal dialysis catheters placement via laparoscopic preperitoneal tunneling technique. Semin Dial 2012; 26:349-54. [PMID: 23013518 DOI: 10.1111/sdi.12003] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Previously we described the technique to lessen complications of continuous ambulatory peritoneal dialysis (CAPD) and to achieve immediate use of the catheter. In this study we evaluated our long-term results of the technique. A total of 61 procedures were carried out in 58 patients from September 2003 to February 2009. All patients were followed in our hospital CAPD clinic. Demographic, medical, operative, postoperative, and other information regarding complications and continued patient management was obtained retrospectively from the patients' medical records and entered into a computerized database. There were 33 men and 25 women. The mean age was 58 years. In 29 of the 58 patients indication of catheter placement was end stage renal failure combined with diabetes mellitus. Mean follow-up time was 33.31 ± 20.11 months. Catheter related complications were outflow obstruction (n=3, 5.2%) and peritonitis (n=2, 3.4%). Etiologies of catheter removal were out flow obstruction (n=2), recovery from renal disease (n=2), peritonitis (n=1), and pregnancy (n=1). The mean catheter survival time was found 5.57 ± 0.17 years. Our long-term results showed that the method ensured accurate placement, preperitoneal fixation, and immediate use of the catheter for routine peritoneal dialysis. Preperitoneal fixation of the catheter decreased outflow obstruction over long-term follow-up.
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Affiliation(s)
- Fatma A Gultekin
- Department of Surgery, School of Medicine, Zonguldak Karaelmas University, Kozlu-Zonguldak, Turkey.
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Crabtree JH. The Use of the Laparoscope for Dialysis Catheter Implantation: Valuable Carry-On or Excess Baggage? Perit Dial Int 2009. [DOI: 10.1177/089686080902900405] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- John H. Crabtree
- Department of Surgery, Southern California Permanente Medical Group, Kaiser Permanente Bellflower Medical Center, Bellflower, California, USA
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Jwo SC, Chen KS, Lee CC, Chen HY. Prospective randomized study for comparison of open surgery with laparoscopic-assisted placement of Tenckhoff peritoneal dialysis catheter--a single center experience and literature review. J Surg Res 2008; 159:489-96. [PMID: 19482306 DOI: 10.1016/j.jss.2008.09.008] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2006] [Revised: 08/31/2008] [Accepted: 09/09/2008] [Indexed: 01/30/2023]
Abstract
BACKGROUND The ideal method for catheter placement in patients undergoing peritoneal dialysis remains debatable. This prospective study intends to clarify whether laparoscopic assisted percutaneous puncture is superior to open surgery. MATERIALS AND METHODS From 2002 to 2006, 77 patients receiving first catheter placement were enrolled and randomized to either an open group of 40 patients or a laparoscopic group of 37 patients. Patient characteristics, operation-related data, procedural complications, and clinical outcome were compared by using the statistical software SPSS ver. 11.5 (SPSS, Chicago, IL). RESULTS Laparoscopy had a longer operative time (68.32+/-31.90 versus 46.68+/-15.99 min; P<0.001), shorter wound length (1.69+/-0.46 versus 2.34+/-0.84 cm; P<0.001), and higher costs (P<0.001) compared with open surgery. Laparoscopy tended to have a higher incidence of pericannular bleeding (21.6% versus 7.5%) and a lower rate of early catheter migration (2.7% versus 15.0%), but its early/late/overall complication rate did not statistically differ. No surgical mortality occurred. Rate and cause of overall mortality or catheter dropout did not statistically differ. Catheter longevity was equivalent in both groups. CONCLUSIONS Laparoscopic assisted percutaneous puncture exhibited no superiority to open surgery. As a matter of fact, open surgery's shorter operative time and reduced equipment requirement can increase cost-effectiveness. Therefore, conventional open surgery is recommended for most patients with primary catheter placement.
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Affiliation(s)
- Shyh-Chuan Jwo
- Division of General Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan, ROC.
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Caliskan K, Nursal TZ, Tarim AM, Noyan T, Moray G, Haberal M. The adequacy of laparoscopy for continuous ambulatory peritoneal dialysis procedures. Transplant Proc 2007; 39:1359-61. [PMID: 17580139 DOI: 10.1016/j.transproceed.2007.02.088] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2006] [Revised: 01/21/2007] [Accepted: 02/23/2007] [Indexed: 11/17/2022]
Abstract
The aim of this study was to determine the safety and efficacy of diagnostic/therapeutic laparoscopy in the management of peritoneal Tenchoff catheter placement in end-stage renal disease patients who had previous abdominal surgery and malfunctioning peritoneal dialysis catheters. From 1999 to 2004, 16 videolaparoscopic procedures were performed in 16 patients who had previous laparotomies. Laparoscopy was performed before peritoneal catheter placement in seven (group 1) and in 9 patients with peritoneal dialysis catheters in place, laparoscopy was performed for the management of catheter dysfunction (group 2). All laparoscopic procedures were performed under general anesthesia. The mean follow-up was 31.5 (range, 11 to 60) months. In group 1, six patients (85.7%), and in group 2, seven patients (77.7%) are still on peritoneal dialysis. Laparoscopy resulted in the placement/salvage of peritoneal dialysis catheter dysfunction. Placement of catheter was accomplished in patients who would have been previously designated as unsuitable candidates. Laparoscopy is a useful tool in every step of a peritoneal dialysis program.
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Affiliation(s)
- K Caliskan
- Başkent University Faculty of Medicine, Department of General Surgery, Ankara, Turkey.
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Mattioli G, Castagnetti M, Verrina E, Trivelli A, Torre M, Jasonni V, Perfumo F. Laparoscopic-Assisted Peritoneal Dialysis Catheter Implantation in Pediatric Patients. Urology 2007; 69:1185-9. [PMID: 17572212 DOI: 10.1016/j.urology.2006.12.033] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2006] [Revised: 09/01/2006] [Accepted: 12/19/2006] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To assess the feasibility and complications of laparoscopic-assisted placement of peritoneal dialysis catheters (PDCs) in pediatric patients. METHODS A total of 15 patients undergoing laparoscopic-assisted PDC insertion were studied. A single 10-mm epigastric port was used, unless concomitant diseases were present. A double-cuffed straight Tenckhoff catheter was implanted, with the deep cuff placed within a preperitoneal tunnel underneath the left rectus muscle. The catheter tip was positioned in the left iliac fossa by stylet wire manipulation under laparoscopic control, with the exit site oriented laterally or downward. Subtotal omentectomy was performed by way of the epigastric port site. The findings were compared with those of a group of patients undergoing open PDC insertion. RESULTS The median operating time was not different in the two groups. In the laparoscopic group, a single port was used in 9 cases, and adhesiolysis was performed in 2. The median time to PD initiation was not different in the two groups, nor were any significant differences found in the infectious complications, leak or obstruction rates, or need for secondary surgical revisions between the two groups. Surgical revision was necessary because of peritonitis in 1, persistent leak in 1, and dislodgement in 2 in the open group and because of blockages in 3 in the laparoscopic group. Laparoscopy allowed for the rescue of two such catheters. CONCLUSIONS The results of our study have shown that laparoscopy allows for careful assessment of the abdominal cavity, recognition and treatment of intraabdominal diseases, and precise placement of PDCs. However, it does not seem to reduce the early catheter-related complication rate. Mechanical obstruction remains a common cause of early catheter malfunction. However, laparoscopy can allow for the rescue of blocked catheters.
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Affiliation(s)
- Girolamo Mattioli
- Department of Paediatric Surgery, Gaslini Children's Hospital and Research Institute, University of Genoa, Genoa, Italy
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Carrillo SA, Ghersi MM, Unger SW. Laparoscopic-assisted peritoneal dialysis catheter placement: a microinvasive technique. Surg Endosc 2007; 21:825-9. [PMID: 17332966 DOI: 10.1007/s00464-006-9148-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2006] [Accepted: 11/30/2006] [Indexed: 11/26/2022]
Abstract
BACKGROUND Peritoneal dialysis is an alternate form of dialysis for patients with end-stage renal disease (ESRD). Although not as widely used as hemodialysis, peritoneal dialysis (PD) has clear advantages, especially those related to patient satisfaction and simplicity. The purpose of our study was to describe and look at the results of a microinvasive technique for placement of peritoneal dialysis catheters under laparoscopy. METHODS From August 2003 to January 2006, 12 patients with ESRD underwent laparoscopic-assisted peritoneal dialysis (LAPD) catheter placement with the microinvasive technique at our institution. Data collected included age, gender, underlying renal disease, and length of operation. Followup was completed for all patients (at least 6 months) and catheter-related morbidity and mortality were also analyzed. RESULTS There were 13 procedures performed (one patient had LAPD catheter placement twice). The average age was 45 years and the most common cause of ESRD was uncontrolled arterial hypertension. Procedural time averaged 33.6 min (range = 24-50 min). Peritoneal dialysis was introduced two weeks after the procedure and no dialysate leaks were observed. There were two catheter-related morbidities; both were catheter exit-site abscesses, one managed surgically with removal of the PD catheter and the other managed conservatively with culture-sensitive antimicrobials. Patient satisfaction was beyond acceptable in 92% of the patients (12 of 13). Average longevity of the catheter was 61 weeks (427 days). There were no mortalities. CONCLUSION LAPD catheter placement is an easy technique with acceptable catheter longevity and minimal morbidity. The microinvasive technique leads to better patient satisfaction and cosmetic outcome without affecting its function. Therefore, we believe that by promoting microinvasive LAPD catheter placement, PD will gain more acceptance among doctors and patients.
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Affiliation(s)
- Sergio A Carrillo
- Department of Surgery, University of Louisville, Louisville, KY 40202, USA.
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Rais-Bahrami S, Romero FR, Lima GC, Kohanim S, Kavoussi LR. Reinstatement of continuous ambulatory peritoneal dialysis after transperitoneal laparoscopic nephrectomy. Urology 2006; 68:715-7. [PMID: 17070339 DOI: 10.1016/j.urology.2006.04.032] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2006] [Revised: 03/26/2006] [Accepted: 04/27/2006] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To assess the early reinstatement of continuous ambulatory peritoneal dialysis (CAPD) after transperitoneal radical nephrectomy. METHODS The medical records of the 3 patients who were using CAPD before laparoscopic radical nephrectomy were retrospectively reviewed. All 3 were reinstated on CAPD during the second postoperative week. RESULTS In these 3 patients, the mean hospital stay was 6 days (range 3 to 9), and CAPD was reinitiated 12.7 days (range 10 to 14) after laparoscopic surgery. During the interim between surgery and reinstituting CAPD, all 3 patients underwent hemodialysis (HD) in the hospital and were discharged to local outpatient HD centers. No difficulties were associated with the transition to CAPD, and no complications had occurred after the reinstatement of regular CAPD regimens at a mean follow-up of 11 months (range 10 to 13) in this group of patients. CONCLUSIONS The results of this study have shown that CAPD can be reinstated within 2 weeks of laparoscopic transperitoneal radical nephrectomy without short-term complications.
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Affiliation(s)
- Soroush Rais-Bahrami
- James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, Maryland 21287-8915, USA
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