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Published on: June 25, 2013
Direct carbon dioxide insufflation of the retroperitoneum under laparoscopic control for renal and adrenal surgery
L de Cannière1, L A Michel, F Lorge
1Surgical Service, University of Louvain Medical School, Mont-Godinne University Hospital, Yvoir, Belgium.
Objective:
Assessment of the videoscopic approach to the retroperitoneal space in the vicinity of the kidney and the adrenal gland.
Design:
Open study.
Setting:
University hospital, Belgium.
Subjects:
10 patients who underwent 11 operations (adrenalectomy, n = 3, nephrectomy, n = 5, partial nephrectomy, n = 2, and renal cystectomy, n = 1).
Interventions:
Direct CO2 insufflation of the retroperitoneal space in order to obtain a convenient retroperitoneal working space for renal and adrenal surgery.
Outcome Measures:
Feasibility, morbidity and mortality.
Results:
8 patients were operated on exclusively by the retroperitoneoscopic approach; 2 required the retroperitoneal and transperitoneal routes to be combined to complete an adrenalectomy. No patients required blood transfusion and no patient died. Median postoperative stay was 3 days.
Conclusion:
The CO2 insufflation technique of the retroperitoneum is safe and reproducible. Nevertheless, far from excluding each other, both approaches-laparoscopic and retroperitoneoscopic-are complementary in difficult cases, particularly for adrenal endoscopic surgery and for larger renal lesions.
