Laparoscopic Peritoneal Dialysis Catheter Placement: with or without omental and catheter fixation

The patient population with end-stage renal disease dependent on dialysis is
increasing. This renal replacement therapy can be haemodialysis or peritoneal
dialysis. Boths options have selected indications. The present study focusses
on patients starting peritoneal dialysis. To facilitate this technique, a
catheter has to be placed in the peritoneal cavityto facilitate unobstructed
in- and outflow of dialysate multiple times a day. An adequate functioning
catheter is essential. Several infectious and non-infectious complications can
hamper peritoneal dialysis. Obstruction and dislocation of the catheter are
described to be influenced by surgical placement technique. There are different
methods of catheter placement but nowadays laparoscopic placement is preferred.
From previous research as the CAPD I trial we know that g=failure rates up to
30 % are seen.
In literature, beneficial outcome is seen with advanced laparoscopic techniques
and fixation of catheter and omentum.
No randomised trial comparing laparoscopic techniques with advanced
laparoscopy have been described so far. This trial will compare the functional
outcome of the PD catheter in both techniques and describe short and median
term complications.

Comparison of functional outcome of PD catheters in the two placement
techniques.
Describing 30 day mortality and short and middle term complications.

Multicenter randomized controlled clinical trial.

Laparoscopic PD catheter placement versus laparoscopic catheter placement with
fixation of catheter and omentum. Both treatment options are part of regular
patient care.

The burden for the patient is not different in the study than in standard care.
Both surgical techniques are performed by experienced surgeons.The techniques
are already routinely performed.
Hospital admission and follow up are the same.