Original dissecting balloon for retroperitoneal laparoscopy: cost-effective alternative to commercially available device.
OBJECTIVE
Creation of an optimal retroperitoneal space is of pivotal importance in laparoscopic retroperitoneal surgery. The aim of this study was to examine the balloon dissecting technique developed at our institution, comparing the costs of our device with that of a commercially available balloon retroperitoneal expander.


METHODS
Twenty patients scheduled to undergo retroperitoneoscopic surgery were randomly divided in two groups. In group 1, retroperitoneal dilation was performed with the commercially available balloon expander. In group 2, we employed our balloon dilator created with two middle finger of No. 8 powder-free surgical gloves tied to a nondisposable 11-mm trocar and filled with 600 mL of saline employing two 60-mL syringes simultaneously. Subjective evaluation of the created space was performed blindly in both groups. Economic evaluation included the costs of the disposable materials and of the time required for dilation.


RESULTS
In all cases, the dilation was considered good. In group 1, the median time required to dilate the retroperitoneal space was 3.15 minutes, whereas in group 2, the median time required was 1.16 minutes, and the time required to dissect the retroperitoneal space was 4.41 minutes (total 5.57 minutes). Considering the costs of the disposable material, the overall costs of creating the retroperitoneal space was 141.95 euro in group 1 and 60.27 euro in group 2 (P < 0.005).


CONCLUSIONS
The original dissecting balloon employed at our institution is easy and fast and offers a valid option for the proper dissection of the retroperitoneal space. Moreover, it was revealed to be cost-effective compared with the commercially available device.
Cestari
Andrea
A
Department of Urology, Vita-Salute University, San Raffaele Hospital, Turro, Milan, Italy. a_cestari@yahoo.it
Guazzoni
Giorgio
G
Naspro
Richard
R
Montorsi
Francesco
F
Riva
Matteo
M
Zanoni
Matteo
M
Rigatti
Lorenzo
L
Buffi
Nicolò
N
Rigatti
Patrizio
P
D002404:Catheterization / Q000191:economics* / Q000295:instrumentation*; D003362:Cost-Benefit Analysis; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D012187:Retroperitoneal Space / Q000601:surgery*; D013525:Surgical Instruments