title: Direct carbon dioxide insufflation of the retroperitoneum under laparoscopic control for renal and adrenal surgery.
abstract: OBJECTIVE
  Assessment of the videoscopic approach to the retroperitoneal space in the vicinity of the kidney and the adrenal gland.
  
  
  METHODS
  Open study.
  
  
  METHODS
  University hospital, Belgium.
  
  
  METHODS
  10 patients who underwent 11 operations (adrenalectomy, n = 3, nephrectomy, n = 5, partial nephrectomy, n = 2, and renal cystectomy, n = 1).
  
  
  METHODS
  Direct CO2 insufflation of the retroperitoneal space in order to obtain a convenient retroperitoneal working space for renal and adrenal surgery.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Surgical Service, University of Louvain Medical School, Mont-Godinne University Hospital, Yvoir, Belgium.
authors.forename: L
authors.initials: L
authors.lastname: de Cannière
authors.forename: L A
authors.initials: LA
authors.lastname: Michel
authors.forename: F
authors.initials: F
authors.lastname: Lorge
authors.forename: A
authors.initials: A
authors.lastname: Rosière
authors.forename: P
authors.initials: P
authors.lastname: Vandenbossche
mesh_terms: D000293:Adolescent; D000307:Adrenal Gland Diseases / Q000601:surgery; D000315:Adrenalectomy / Q000379:methods*; D000328:Adult; D000368:Aged; D002648:Child; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000601:surgery; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D011028:Pneumoperitoneum, Artificial / Q000379:methods*