Retroperitoneal laparoscopic nephrectomy: animal and human anatomic studies

Retroperitoneal laparoscopic nephrectomy with CO2 insufflation was performed in 11 goats. The hemodynamic and blood gas repercussions of retroperitoneal laparoscopy were compared during the first 30 minutes with those induced by intraperitoneal laparoscopy. With the animal placed in the left lateral supine position, the hemodynamic and blood gas changes were similar with the two techniques and had a similar time course. The technical feasibility of retroperitoneal laparoscopy in animals was confirmed in the fresh human cadaver. The technical feasibility of retroperitoneal laparoscopy and the absence of any particular hemodynamic and blood gas repercussions encourage us to develop this approach for clinical upper urinary tract surgery.