Técnica Quirúrgica de colocación de catéter de Tenckhoff Laparoscópico: Reporte de serie de casos a propósito de una técnica propia

Abstract

Introduction: Peritoneal dialysis is an extrarenal wastewater treatment technique that utilizes the peritoneal membrane and its capacity for osmosis and diffusion of solutes from the peritoneum to plasma and vice versa. Its development as a treatment for this condition has been marked by milestones throughout history. The peritoneal catheter is a round tube-like prosthesis, generally made of silicone, that can be placed using open surgical techniques, laparoscopic approaches, and even percutaneous approaches, facilitating the applicability of peritoneal dialysis as a therapeutic strategy for CKD. Objective: To describe the procedure for laparoscopic placement of a Tenckhoff catheter in combination with a percutaneous approach through a case series. Methods: Prospective and longitudinal study of 14 patients with CKD, with percutaneous Tenckhoff catheter placement under laparoscopic vision (Nov. 2023 - Dec. 2024). Age, sex, diagnosis, cause of CKD, surgical time, complications, and effectiveness were analyzed. Results: The mean age was 59 years (3:1 men), with hypertension (60%) as the main comorbidity. The mean surgical time was 18 minutes. The only postoperative complication (30 days) was catheter dysfunction due to obstruction in 7.1%. There were no peritoneal fluid leaks, unlike open surgery (2.6-22%), attributed to paramedian placement and a long subcutaneous tunnel. Conclusion: Our technique describes a simple procedure through a 5- or 10-mm trocar that facilitates direct visualization of the abdominal cavity and allows for percutaneous placement of the peritoneal catheter under direct vision, offering greater safety and a lower rate of complications associated with the technique. During the study, one case of obstruction was observed that requires follow-up.