Retroperitoneal renal laparoscopy

Abstract

The retroperitoneal laparoscopic approach to the kidney offers a minimally invasive access that mimics the open surgical techniques of renal surgery. It allows renal surgery without violation of the peritoneal cavity with its attendant complications such as bowel injury and ileus. Over the last two decades, all renal surgery has been shown to be feasible through this technique. This includes complicated procedures such as a donor nephrectomy and radical nephroureterectomy for upper tract transitional cell cancers. We began performing retroperitoneoscopic renal surgery in the early 1990s and have developed a number of modifications to existing techniques so as to make this surgery easy and cost effective. In this review, we discuss the evolution of retroperitoneoscopic renal surgery, the indications, techniques and outcome of all types of retroperitoneoscopic renal surgery.

Complete retroperitoneal laparoscopic nephroureterectomy with bladder cuff excision for upper tract urothelial carcinoma without patient repositioning: a single-center experience

“…3 In addition, laparoscopic surgery, characterized by its safety, effectiveness, and minimal injury, has gradually replaced open surgery and is now widely applied in the clinical setting. With the advent of laparoscopic instruments and technologies, various strategies have been suggested for the treatment of UTUC, including retroperitoneal routes, 4,5 the transperitoneal route, 6 and single-site retroperitoneal laparoscopic nephroureterectomy (RLNU). 7,8 Nonetheless, all of these surgical techniques have a common problem: difficulty dealing with the vesicoureteral junction under laparoscopic conditions.…”

A Comparison of Technique Modifications in Laparoscopic Donor Nephrectomy: A Systematic Review and Meta-Analysis

“…Advantages of hand-assistance are the possibility of manual compression in case of bleeding, quicker kidney removal and better spatial orientation, in theory leading to less blood loss (EBL), shorter WIT1 and shorter operation time (ORT) when compared to conventional laparoscopy [ 13 ]. The retroperitoneal access theoretically lowers the risk of injuries to intra-abdominal organs [ 14 , 15 ]. Others claim LESS is associated with quicker postoperative recovery, less pain and better cosmetic outcome because the entire incision is hidden in the umbilicus [ 16 , 17 ].…”

A modification with threading cannula needle-assisted 4-point suspension fixation for retroperitoneal laparoscopic pyeloplasty in children with ureteropelvic junction obstruction: a cohort study in single center

“…Furthermore, if urine leakage occurs, it will accumulate in the retroperitoneum which is helpful for drainage as abdominal organs are avoided. In addition, it is still possible to perform a second surgery by the transperitoneal approach after the retroperitoneal procedure is unsuccessful [17–19].…”