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Laparoscopic versus open peritoneal dialysis catheter insertion, the LOCI-trial: a study protocol

Sander M Hagen1*, Arjan M van Alphen2, Jan NM IJzermans1 and Frank JMF Dor1

Author Affiliations

1 Department of Surgery, Erasmus MC, University Medical Center, Rotterdam, The Netherlands. PO BOX 2040, 3000 CA, Rotterdam, The Netherlands

2 Department of Nephrology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands

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BMC Surgery 2011, 11:35  doi:10.1186/1471-2482-11-35

Published: 20 December 2011



Peritoneal dialysis (PD) is an effective treatment for end-stage renal disease. It allows patients more freedom to perform daily activities compared to haemodialysis. Key to successful PD is the presence of a well-functioning dialysis catheter. Several complications, such as in- and outflow obstruction, peritonitis, exit-site infections, leakage and migration, can lead to catheter removal and loss of peritoneal access. Currently, different surgical techniques are in practice for PD-catheter placement. The type of insertion technique used may greatly influence the occurrence of complications. In the literature, up to 35% catheter failure has been described when using the open technique and only 13% for the laparoscopic technique. However, a well-designed randomized controlled trial is lacking.


The LOCI-trial is a multi-center randomized controlled, single-blind trial (pilot). The study compares the laparoscopic with the open technique for PD catheter insertion. The primary objective is to determine the optimum placement technique in order to minimize the incidence of catheter malfunction at 6 weeks postoperatively. Secondary objectives are to determine the best approach to optimize catheter function and to study the quality of life at 6 months postoperatively comparing the two operative techniques.


This study will generate evidence on any benefits of laparoscopic versus open PD catheter insertion.

Trial registration

Dutch Trial Register NTR2878