Keramati Mohammad Reza, Abbaszadeh-Kasbi Ali, Keshvari Amir
Tehran University of Medical Sciences, Tehran, Iran.
Tehran University of Medical Sciences, Tehran, Iran
Perit Dial Int. 2018 May-Jun;38(3):187-191. doi: 10.3747/pdi.2017.00195. Epub 2018 Feb 7.
Prophylactic laparoscopic omentopexy is a safe technique to prevent peritoneal dialysis (PD) catheter obstruction. For the first time, we would like to describe a surgical technique in which the omentopexy is done using a single PD port which is used for the omentopexy, PD catheter insertion, and the rectus sheath tunneling of the catheter.
The surgical method of the omentopexy using the PD port (US Patent 20170119430) will be thoroughly described. To evaluate the surgical method, we performed the procedure in 15 consecutive patients with chronic renal failure and followed up the patients.
No intraoperative complication was observed. During the follow-up period, catheter flow failure due to omental wrapping was found in none of the patients. No other complication including exit-site infection, peritonitis, or catheter leakage was detected.
Using this technique the catheter can not only be implanted through a proper and long rectus sheath, but the omentopexy can also be done without an additional port. This can reduce port-site complications and dialysis fluid leakage.
预防性腹腔镜大网膜固定术是预防腹膜透析（PD）导管梗阻的一种安全技术。我们首次描述一种手术技术，即使用单个PD端口进行大网膜固定术，该端口用于大网膜固定术、PD导管插入以及导管的腹直肌鞘隧道化。
将详细描述使用PD端口进行大网膜固定术的手术方法（美国专利20170119430）。为评估该手术方法，我们对15例连续性慢性肾衰竭患者实施了该手术并对患者进行随访。
未观察到术中并发症。在随访期间，无一例患者因网膜包裹出现导管引流失败。未检测到其他并发症，包括出口处感染、腹膜炎或导管渗漏。
使用该技术，导管不仅可以通过合适的长腹直肌鞘植入，而且大网膜固定术无需额外端口即可完成。这可以减少端口部位并发症和透析液渗漏。
