Closed technique for the creation of retroperitoneal working space for symptomatic renal cysts.
OBJECTIVE
To evaluate the feasibility and safety of the closed technique (CT) with Veress needle for the creation of retroperitoneal working space (RWS) for the retroperitoneoscopic ablation of symptomatic renal cysts by comparison with the open technique (OT).


METHODS
In this series of 412 patients who underwent retroperitoneoscopic ablation of symptomatic renal cysts, RWS was created by OT in 231 patients and CT in 181 patients, respectively. The time to create RWS, operative time, and complications were analyzed.


RESULTS
Creation of RWS and retroperitoneoscopic cyst ablation were completed successfully in all cases. The time to create RWS by CT was significantly shorter than that by OT (6.4 ± 1.2 vs 9.6 ± 1.2 min, P < 0.01). The operative time was shorter with CT than with OT (50.5 ± 6.5 vs 52.5 ± 6.7 min, P < 0.01). Subcutaneous emphysema developed in five (2.16%) of 231 patients undergoing OT and one (0.55%) of 181 patients undergoing CT. Port-site gas leakage was observed in six patients undergoing OT.


CONCLUSIONS
Our study shows that CT with Veress needle for the creation of RWS for symptomatic renal cysts is feasible and safe in experienced hands, reducing troublesome port-site gas leakage and subcutaneous emphysema.
Department of Urology, Affiliated Hospital of Xuzhou Medical College, Xuzhou, China. chengjingzh@gmail.com
Cheng-Jing
CJ
Zhang
Ren-Fu
RF
Chen
Hai-Tao
HT
Zhu
Ru-Min
RM
Wen
Song
S
Xue
Wang
W
Li
Hai-Long
HL
Li
Xiao-Qing
XQ
Sun
D055011:Ablation Techniques / Q000379:methods*; D000328:Adult; D000368:Aged; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D052177:Kidney Diseases, Cystic / Q000473:pathology / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009339:Needles; D061646:Operative Time; D012187:Retroperitoneal Space; D012189:Retrospective Studies; D013352:Subcutaneous Emphysema / Q000453:epidemiology / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome