Laparoscopic reinsertion/exchanges of peritoneal dialysis catheters using the modified Y-TEC(®) system.

TECHNIQUE The method employs the use of water-based lubricant jelly, such as K-y® Jelly (Johnson & Johnson, new Jersey, US) or instillagel® (Clinimed Ltd, buckinghamshire, UK). The viscous nature of the gel allows application to the metalwork and surrounding soft tissues. it also ‘catches’ any particulate matter produced. both the abovenamed jellies are water soluble and non-toxic, allowing them to be washed from the wound. The clear and colourless nature allows visualisation of the soft tissues and metalwork, and its high water content serves as a lubricant, which in theory may reduce the heat generated by the burr. We apply a thin layer of gel to the plate and surrounding soft tissues prior to cutting the plate. The majority of the gel containing the metal particles is removed using a mcdonald elevator. The wound is then washed out with copious amounts of normal saline.