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Clinical |
Department of Nephrology,1 Department of Surgery,2 Deutsche Klinik für Diagnostik, Wiesbaden, Germany
Correspondence to: T. Mettang, Department of Nephrology, Deutsche Klinik für Diagnostik, Aukammallee 33, 65191 Wiesbaden, Germany. t_mettang{at}t-online.de
Background: At present there are various more or less
invasive surgical and laparoscopic ways to place a catheter suitable for
peritoneal dialysis (PD); however, once the catheter is in place, there is no
possibility to inspect the peritoneal cavity without de novo
laparotomy or laparoscopy. Patients and Methods: To establish a minimally invasive
technique and allowing for maximal options, we used a PD catheter with an
extra large inside diameter of 3.5 mm. Because of the enlarged inner diameter
of 3.5 mm (compared to 2.6 mm in standard Tenckhoff catheters), this device
can be passed by a very thin video-endoscope with an external diameter of 2.8
mm. Using a stepwise approach, we applied this device in placing PD catheters
in 2 patients. The procedure could be done without complications. Both
patients were doing well 4 and 6 months later, respectively, without any
PD-related complications. Intraperitoneal view by the endoscope was limited;
an attempt to obtain a peritoneal biopsy failed. Conclusions: If the drawbacks of this method can be
overcome it will have a wide spectrum of applications (i.e.,
inspection of the peritoneal cavity and obtaining peritoneal biopsies at any
time during PD treatment). In this way it can be used scientifically and
clinically when a problem of flow or ultrafiltration occurs or when
encapsulating sclerosing peritonitis is suspected.
KEY WORDS: Endoscopic; catheter; placement; transluminal.
Received 30 July 2008; accepted 6 February 2009.
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