Retroperitoneal laparoscopy

Retroperitoneoscopic Nephrectomy for Benign Diseases of the Kidney

“…The relative contraindications are nonfunctioning kidneys due to renal tuberculosis, pyonephrosis, infected pyelonephritic kidneys due to stone disease, posttraumatic atrophy, post-ESWL therapy for renal stones, cases with severe perinephritis, and patients with previous retroperitoneal surgery [17][18][19][20]. However, in my experience, a substantial number of these cases can be dealt with using modified techniques as described later.…”

“…Cost-saving techniques for prevention of surgical emphysema and avoidance of subfascial balloon have also been described by the author [30]. Keeley and Tolley [17] reviewed the technique of retroperitoneal laparoscopy and described various currently used methods including blunt dissection, Foley catheter balloon, saline distension balloon, trocar-mounted distension balloon and gasless techniques.…”

“…The advantage of inflating the balloon underneath the fascia is ready visualization of the kidney (target organs). Gasless technique (automated body wall retractor) has been used for preperitoneal space and has similarly been described for retroperitoneal space [17]. However, its use is limited as it is extremely difficult to manage so many instruments in a small area.…”

“…Retroperitoneoscopy has certain distinct advantages over transperitoneal access as it affords direct access to the retroperitoneal genitourinary organs [17,18]. The recent past has witnessed emergence of retroperitoneoscopic nephrectomy (RPN) worldwide including the largest experience of the author.…”

“…The recent past has witnessed emergence of retroperitoneoscopic nephrectomy (RPN) worldwide including the largest experience of the author. The indications, technique, safety and efficacy have been clearly defined [17][18][19][20]. It has also been concluded in a comparative study with open surgical nephrectomy that RPN is as effective as open nephrectomy for benign kidney diseases with lower postoperative pain, shorter hospital stay, earlier recuperation and excellent cosmesis [21,22].…”