Retroperitoneal and pelvic extraperitoneal laparoscopy: an international perspective

Area of Science:

• Urologic Surgery
• Minimally Invasive Procedures
• Laparoscopic Techniques

Background:

• Laparoscopic surgery has evolved, with retroperitoneal and pelvic extraperitoneal approaches gaining traction.
• Assessing current trends and technical preferences is crucial for understanding adoption rates.

Purpose of the Study:

• To evaluate the evolving use and technical preferences for retroperitoneal and pelvic extraperitoneal laparoscopy in urologic surgery.
• To document practice trends and complication rates associated with these minimally invasive techniques.

Main Methods:

• A global survey was conducted among 36 selected urologic laparoscopic centers.
• Data on the types and volume of laparoscopic procedures, including approach (transperitoneal vs. retroperitoneal/extraperitoneal), were collected via questionnaire.

Main Results:

• Twenty-four centers responded, reporting 3988 laparoscopic procedures (2945 transperitoneal, 1043 retroperitoneal/extraperitoneal).
• Common retroperitoneal/extraperitoneal procedures included nephrectomy, pelvic lymph node dissection, and bladder neck suspension.
• The ratio of retroperitoneal/extraperitoneal to transperitoneal procedures shifted significantly from 26:74 in 1993 to 51:49 in 1996, indicating increased adoption.

Conclusions:

• Retroperitoneoscopy and pelvic extraperitoneoscopy are valuable additions to the urologic laparoscopic surgical toolkit.
• The overall major complication rate for retroperitoneal/extraperitoneal laparoscopy was 4.7%, with visceral and vascular complications noted.