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Retroperitoneoscopy: experience with 200 cases

J J Rassweiler1, O Seemann, T Frede

  • 1Department of Urology, Stadtkrankenhaus Heilbronn and Klinikum Mannheim, Clinical Faculty of Medical School, University of Heidelberg, Germany.

The Journal of Urology
|September 29, 1998
PubMed
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Retroperitoneoscopy is a safe and reproducible laparoscopic technique for urological procedures. Experience with over 200 cases shows simplified access and acceptable complication rates for routine clinical application.

Area of Science:

  • Urology
  • Minimally Invasive Surgery
  • Laparoscopic Surgery

Background:

  • Retroperitoneal access is a standard approach for open urological surgery.
  • Laparoscopic surgery has increasingly utilized the retroperitoneal route.
  • The balloon dissecting technique has facilitated laparoscopic retroperitoneal access.

Purpose of the Study:

  • To present the experience with retroperitoneoscopy in 200 cases.
  • To evaluate the safety, reproducibility, and learning curve of retroperitoneoscopy.
  • To assess the applicability of retroperitoneoscopy for various urological procedures.

Main Methods:

  • A total of 200 retroperitoneoscopic procedures were performed in 197 patients between December 1992 and October 1997.
  • Procedures included nephrectomies, renal cyst resections, nephropexies, and others.

Related Experiment Videos

  • Retroperitoneal space dissection was achieved using balloon catheters, balloon trocar systems, or finger dissection.

    • Main Results:

    • Procedures were classified by difficulty: 38% simple, 51% difficult, 11% very difficult.
    • A learning curve was observed in the first 50 cases, with higher complication and conversion rates.
    • In the last 50 cases, complication (2%), conversion (4%), and reintervention (2%) rates were acceptable for clinical use.

    Conclusions:

    • Retroperitoneoscopy access has been significantly simplified after extensive experience.
    • The retroperitoneoscopic procedure is standardized, safe, and reproducible.
    • This technique is suitable for routine clinical application in urological surgery.