A 48-year-old man with chronic renal failure underwent placement of a continuous ambulatory peritoneal dialysis (CAPD) eatheter using a microlaparoscopical surgical technique. He had previously undergone appendectomy due to appendicitis with panperitonitis and left nephrectomy due to hydronephrosis of unknown origin. Under general anethesia, the patient was placed in a supine position. The 2mm Minisitegold was inserted through a 2mm introducer placed in the left paraumbilical area. Multiple adhesions between the bowel or emontum and the peritoneal surface of the anterior abdominal wall were detected. Adhesiolysis was perfomed with a Microscissors, then a 10mm port was placed in another site. A CAPD catheter was inserted through this second port, and the distal end of the catheter was guided into the pelvic cavity under direct visualization. To prevent leakage, the peritoneum around the catheter was closed by Endoclose and 1-0 Vycryl. This technique proved to be safe, effective and non-invasive.
Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)