Laparoscopic operative retroperitoneoscopy: use of a new device

Attempts at retroperitoneoscopy have mostly failed in the past due to the inability to create an effective pneumoretroperitoneum because of the dense areolar tissue binding the fat in the retroperitoneum, which could not be broken down merely by pneumo-insufflation. The newly devised balloon breaks the septae, lifts the peritoneum atraumatically and creates a workable space in the retroperitoneum. The view of the retroperitoneal structures provided is satisfactory. With this balloon dissector we have performed laparoscopic ureterolithotomy, renoscopy and renal biopsy, para-aortic lymph node biopsy and ligation of the internal spermatic vein.