Tomohide Hori, Masaya Nakauchi, Fumitaka Oike, Takahiro Tanaka, Daigo Gunji, Noriyuki Okada, Department of Surgery, Mitsubishi Kyoto Hospital, Kyoto 615-8507, Japan.
World J Gastrointest Surg. 2013 Oct 27;5(10):268-71. doi: 10.4240/wjgs.v5.i10.268.
A 40-year-old male underwent tube placement surgery for continuous ambulatory peritoneal dialysis (CAPD). A 2-cm skin incision was made, and the peritoneum was reflected enough to perform secure fixation. A swan-necked, double-felted silicone CAPD catheter was inserted, and the felt cuff was sutured to the peritoneum to avoid postoperative leakage. An adequate gradient for tube fixation to the abdominal wall was confirmed. The CAPD tube was passed through a subcutaneous tunnel. Aeroperitoneum was induced to confirm that there was no air leakage from the sites of CAPD insertion. Two trocars were placed, and we confirmed that the CAPD tube led to the rectovesical pouch. Tip position was reliably observed laparoscopically. Optimal patency of the CAPD tube was confirmed during surgery. Placement of CAPD catheters by laparoscopic-assisted surgery has clear advantages in simplicity, safety, flexibility, and certainty. Laparoscopic technique should be considered the first choice for CAPD tube insertion.
一位 40 岁男性接受了持续非卧床腹膜透析(CAPD)的置管手术。做了一个 2cm 的皮肤切口,充分显露腹膜以进行安全固定。插入了一个天鹅颈、双层毡制的硅胶 CAPD 导管,并将毡制袖口缝合到腹膜上,以避免术后渗漏。确认了导管固定到腹壁的足够梯度。将 CAPD 管穿过皮下隧道。气腹术诱导以确认 CAPD 插入部位无空气泄漏。放置了两个 Trocar,我们确认 CAPD 管通向直肠膀胱窝。腹腔镜下可靠地观察到尖端位置。在手术中确认了 CAPD 管的通畅性。腹腔镜辅助手术置管在简单性、安全性、灵活性和确定性方面具有明显优势。腹腔镜技术应被视为 CAPD 管插入的首选方法。