title: Retroperitoneoscopy versus laparoscopy in piglets: ventilatory and thermic repercussions.
abstract: OBJECTIVE
  Endoscopic surgery of the retroperitoneal space in children is developing. During preliminary clinical experience, the authors were surprised by the differences observed in comparison with laparoscopic pneumpoeritoneum (PNOP); retropneumpoeritoneum (RPNOP) seemed to have less ventilatory repercussions.
  
  
  METHODS
  The authors therefore undertook a study on animal models. Six suckling pigs, newly weaned, each weighing 10 kg successively underwent, at 8-day intervals and in random sequence, a right RPNOP with kidney and vena cava dissection, with insufflation of CO2 at 10 mm Hg of pressure and a PNOP with the same pressure of 10 mm Hg.
  
  
  RESULTS
  P(ET)CO2 increased during PNOP, and it remained stable during during RPNOP (P = .035). The ventilatory peak airway pressures (PawP) increased during PNOP, but were not modified during RPNOP (P = .0001). Temperature decreased with time (P = .0001) without difference between the two procedures (P = .34).
  
  
  CONCLUSIONS
  RPNOP was not associated with any adverse effects on the ventilation despite the insufflation pressure of 10 mm Hg, which allowed a satisfactory working area to be created. Operations by RPNOP could be developed in children with fewer respiratory repercussions than those observed during laparoscopy at an equivalent level of pressure.
authors.affiliation: IRCAD/EITS Hôpitaux Universitaires de Strasbourg, France.
authors.forename: P
authors.initials: P
authors.lastname: Diemunsch
authors.forename: F
authors.initials: F
authors.lastname: Becmeur
authors.forename: P
authors.initials: P
authors.lastname: Meyer
mesh_terms: D000818:Animals; D000833:Animals, Suckling; D001831:Body Temperature; D004724:Endoscopy; D004947:Esophagus / Q000502:physiology; D010535:Laparoscopy; D011028:Pneumoperitoneum, Artificial; D011859:Radiography; D015656:Respiratory Mechanics; D012187:Retroperitoneal Space / Q000000981:diagnostic imaging* / Q000601:surgery*; D013552:Swine