Complications - Peritoneal dialysis: Laparoscopic-assisted catheter insertion in CAPD

  1. Prevention and treatment of intraoperative complications

    Injury to abdominal organs

    •  Minilaparotomy for open establishment of the pneumoperitoneum
    • Atraumatic dissection
    • Careful intraabdominal application of electrosurgery
    • Dissection only under direct view

    Bleeding

    • Transillumination of the abdominal wall
    • Subtle dissection
    • Introducer set best inserted through the medial rectus muscle

    Almost all injuries seen in laparoscopic surgery are reasonably easy to control if they are noticed immediately and treated appropriately, e.g., by arresting any bleeding, suturing any intestinal injuries. In case of doubt: Convert to open surgery!

  2. Prevention and treatment of postoperative complications

    Secondary bleeding

    • Compression dressing, suture ligation, revision surgery

    Peritonitis

    • Revision laparoscopy, possibly laparotomy

    Wound infection

    • Open wound care

    Cutaneous emphysema

    • Disappears by itself

    Postlaparoscopic shoulder pain syndrome

    • Symptomatic treatment
Prevention and treatment of catheter specific complications

KinkingKinking may be avoided by deep subcutaneous tunneling, palpation of the subcutaneous course

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