Laparoscopic Surgeon

Interventional Nephrologist
Laparoscopic Surgeon
Y-TEC® Training Video
Y-TEC® Instructions
References

Peritoneoscopic Implantation System for Peritoneal Dialysis Catheters

The success of Peritoneal Dialysis depends primarily on a single factor—
the viability of the peritoneal catheter.
The Y-TEC® system enables you to significantly improve catheter longevity, reduce catheter problems, lower costs, and increase patient acceptance of peritoneal dialysis.

The Y-TEC® System for implantation of peritoneal dialysis (PD) catheters is a well-established procedure. Since 1983, over 28 articles have been published in peer-review journals or at international conferences(view references). All these articles and reports (randomized and retrospective) have consistently shown superior short and long-term outcomes and longevity.

VP 210 STD Disposable PacClick Here for Details

The laparoscopic Y-TEC® system is designed to be used with the hospital's existing laparoscopic instruments and optional video equipment. After standard laparoscopic insertion into and the inspection of the abdomen, the surgeon uses the contents of the Y-TEC® VP-210 pac to implant the catheter. It contains the patented Quill® Guide Assembly, the patented Cuff Implantor® Tool, small and large Dilators, and Tunnelor® Tool. The VP-210 pac is shown to the right.

This pac and procedure can be used to implant almost all PD catheters including the Flex-Neck®, Swan-Neck™, and conventional catheters. (The Toronto Western™ and Missouri Swan-Neck™ catheters cannot be implanted with this technique.)

The Y-TEC® laparoscopic portion of the PD catheter implantation is briefly described below.

Y-TEC® Procedure

See Instruction Brochure and qualified, recognized standard medical texts and/or related literature for specific details, results, risks, and prescription information.

  1. The Quill® Guide after laparoscopic examination of the abdomen and removal of the cannula and trocar.
  2. The Quill® Guide is dilated in two stages.
  3. The rectus cuff of the catheter is inserted into the abdominal wall via the Y-TEC® Cuff Implantor® Tool.
  4. The catheter, stiffened with an internal stylette, is inserted into the abdomen via the Quill® Guide.
  5. After removal of the Cuff Implantor® Tool, the Quill® Guide and stylette, and after catheter patency has been established, the catheter is tunneled via the Y-TEC® Tunnelor® Tool.
Twenty-eight published clinical studies or reports of the Y-TEC® procedure all report comparable data indicating a reduction of catheter problems and major improvements in PD catheter longevity compared to other implantation techniques. The studies show:
  • Catheter survival at 8 weeks is 95-98%.
  • Exit site infection frequency is 1-5%.
  • Tunnel infection frequency is 0-1%.
  • Leak frequency is 0-1%. (Most are self-sealing with additional 24 hours of dry abdomen.)
  • Catheter survival at 24 months is 70-84%.
By contrast, National Institute of Health (USA) data shows significantly poorer results for surgical (cut down) and guide wire techniques.

The Y-TEC® procedure is designed as a system of instruments and disposables to enable the surgeon to implant peritoneal dialysis catheters easily, accurately, and with a very high degree of confidence and success. The Y-TEC® VP-210 pac enables the surgeon to enter the peritoneum with minimal trauma and discomfort to the patient.

Conclusion

The Y-TEC® system of catheter implantation has shown that “...peritoneoscopic placement of the Tenckhoff (catheter) is fast, safe and a cost effective method of catheter placement that yields excellent results...” and with “...little perioperative mobility, immediate availability for use without leakage or outflow obstruction and remarkably reduced incidence of tunnel infection.”

Click here to download a printable brochure on this information.

Click here to view medical journal references.