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Comparison between closed and open techniques for creating a retroperitoneal space for retroperitoneoscopic renal surgery in children

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Abstract

Aim

During retroperitoneoscopic renal surgery (RPRS), the open technique (OT) for trocar insertion is always associated with CO2 leakage around the first trocar, while the closed technique (CT) involves advancing an optical trocar into the retroperitoneal space (RS) under direct vision. We are the first to compare OT with CT.

Methods

Forty-one cases of RPRS performed for pyeloplasty (31), hemi-nephrectomy (4), nephrectomy (4), stone removal (1), and cyst excision (1) were studied. The initial 5 mm trocar was inserted using OT (n = 11) or CT (n = 30). The tip of a telescope was used for blunt dissection of the retroperitoneum to create the RS.

Results

Ages and weights at RPRS were similar (OT versus CT: 7.3 versus 7.1 years; 25.4 versus 25.0 kg; respectively). In CT, RS access was significantly faster (38.2 versus 5.6 min), RS was created significantly quicker (77.7 versus 31.9 min), and narcotic usage was significantly less (4.0 versus 1.5 days). In OT, CO2 leaked in 11/11 and the retroperitoneum was torn in 3/11. In CT there was no leakage and no tearing.

Conclusions

CT is quicker and safer than OT during RPRS.

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Authors and Affiliations

  1. Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, 113-8421, Japan

    Hiroyuki Koga, Manabu Okawada, Takashi Doi, Go Miyano, Geoffrey J. Lane & Atsuyuki Yamataka

Authors
  1. Hiroyuki Koga
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  2. Manabu Okawada
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  3. Takashi Doi
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  4. Go Miyano
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  5. Geoffrey J. Lane
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  6. Atsuyuki Yamataka
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Corresponding author

Correspondence to Hiroyuki Koga.

Additional information

This paper was presented at the 51st Annual Meeting of Japanese Society of Pediatric Surgeons, May 8–10, 2014 in Osaka, Japan.

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Koga, H., Okawada, M., Doi, T. et al. Comparison between closed and open techniques for creating a retroperitoneal space for retroperitoneoscopic renal surgery in children. Pediatr Surg Int 30, 933–936 (2014). https://doi.org/10.1007/s00383-014-3566-y

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  • DOI: https://doi.org/10.1007/s00383-014-3566-y

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