title: Retroperitoneal Laparoscopy in Dogs: Access Technique, Working Space, and Surgical Anatomy.
abstract: OBJECTIVE
  To develop and describe a laparoscopic retroperitoneal access technique, investigate working space establishment, and describe the surgical anatomy in the retroperitoneal space as an initial step for clinical application of retroperitoneal laparoscopy in dogs.
  
  
  METHODS
  Cadaveric and experimental study.
  
  
  METHODS
  Cadaveric (n=8) and healthy (n=6) adult dogs.
  
  
  METHODS
  The retroperitoneal access technique was developed in 3 cadavers based on the human technique and transperitoneal observation. Its application and working space establishment with carbon dioxide (CO2) insufflation alone was evaluated in 5 cadavers by observing with a transperitoneal telescope and in 6 live dogs by repeated computed tomography (CT) scans at pressure of 0, 5, 10, and 15 mmHg. Recordings of retroperitoneoscopy as well as working space volume and linear dimensions measured on CT images were analyzed.
  
  
  RESULTS
  Retroperitoneal access and working space establishment with CO2insufflation alone were successfully performed in all 6 live dogs. The only complication observed was in 1 dog that developed subclinical pneumomediastinum. As pressure increased, working space was established from the ipsilateral to the contralateral side, and peritoneal tearing eventually developed. Working space volume increased significantly from 5 mmHg and linear dimensions increased significantly from 0 to 10 mmHg. With pneumo-retroperitoneum above 5 mmHg, retroperitoneal organs, including kidneys and adrenal glands, were easily visualized.
  
  
  CONCLUSIONS
  The retroperitoneal access technique and working space establishment with CO2insufflation starting with 5 mmHg and increasing to 10 mmHg provided adequate working space and visualization of retroperitoneal organs, which may allow direct access for retroperitoneal laparoscopy in dogs.
authors.affiliation: Department of Veterinary Clinical Science, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Seoul, Republic of Korea.
authors.forename: Junemoe
authors.initials: J
authors.lastname: Jeong
authors.affiliation: Department of Veterinary Clinical Science, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Seoul, Republic of Korea.
authors.forename: Jonghyeok
authors.initials: J
authors.lastname: Ko
authors.affiliation: Department of Veterinary Clinical Science, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Seoul, Republic of Korea.
authors.forename: Hyunjoo
authors.initials: H
authors.lastname: Lim
authors.affiliation: Department of Veterinary Clinical Science, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Seoul, Republic of Korea.
authors.forename: Oh-Kyeong
authors.initials: OK
authors.lastname: Kweon
authors.affiliation: Department of Veterinary Clinical Science, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Seoul, Republic of Korea.
authors.forename: Wan Hee
authors.initials: WH
authors.lastname: Kim
mesh_terms: D000818:Animals; D002102:Cadaver; D002245:Carbon Dioxide / Q000502:physiology; D004285:Dogs / Q000601:surgery*; D007327:Insufflation / Q000379:methods / Q000662:veterinary; D010535:Laparoscopy / Q000379:methods / Q000662:veterinary*; D008297:Male; D010865:Pilot Projects; D011312:Pressure; D012187:Retroperitoneal Space / Q000033:anatomy & histology* / Q000601:surgery*
chemical_list: D002245:Carbon Dioxide