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Retroperitoneal renal laparoscopy

  • Urology – Review
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Abstract

The retroperitoneal laparoscopic approach to the kidney offers a minimally invasive access that mimics the open surgical techniques of renal surgery. It allows renal surgery without violation of the peritoneal cavity with its attendant complications such as bowel injury and ileus. Over the last two decades, all renal surgery has been shown to be feasible through this technique. This includes complicated procedures such as a donor nephrectomy and radical nephroureterectomy for upper tract transitional cell cancers. We began performing retroperitoneoscopic renal surgery in the early 1990s and have developed a number of modifications to existing techniques so as to make this surgery easy and cost effective. In this review, we discuss the evolution of retroperitoneoscopic renal surgery, the indications, techniques and outcome of all types of retroperitoneoscopic renal surgery.

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References

  1. Wickham JEA (ed) (1979) The surgical treatment of renal lithiasis. In: Urinary calculus disease. Churchill Livingstone, New York, 145–198

  2. Bay-Nielsen H, Schultz A (1982) Endoscopic retroperitoneal removal of stones from the upper half of the ureter. Scand J Urol Nephrol 16:227–228

    Article  PubMed  CAS  Google Scholar 

  3. Clayman RV, Preminger GM, Franklin JF, Curry T, Peters PC (1985) Percutaneous uretero ilithotomy. J Urol 133:671–673

    PubMed  CAS  Google Scholar 

  4. Clayman RV, Kavoussi LR, Soper NJ, Dierks NJ, Meretyk S, Darcy MD, Roemer FD, Pingleton ED, Thomson PG, Long SR (1991) Laparoscopic nephrectomy: initial Case report. J Urol 146:278–281

    Google Scholar 

  5. Gaur DD (1992) Laparoscopic operative retroperitoneoscopy: use of a new device. J Urol 148:1137–1139

    PubMed  CAS  Google Scholar 

  6. Gaur DD, Agarwal DK, Purohit KC (1993) Retroperitoneal laparoscopic nephrectomy: initial case report. J Urol 149(1):103–105

    PubMed  CAS  Google Scholar 

  7. Gaur DD (1993) Retroperitoneal laparoscopic ureterolithotomy. World J Urol 11(3):175–177

    Article  PubMed  CAS  Google Scholar 

  8. Hemal AK, Aron M, Gupta NP, Seth A, Wadhwa SN (1999) The role of retroperitoneoscopy in the management of renal and adrenal pathology. BJU Int 83(9):929–936

    Article  PubMed  CAS  Google Scholar 

  9. Hemal AK, Gupta NP, Wadhwa SN, Goel A, Kumar R (2001) Retroperitoneoscopic nephrectomy and nephroureterectomy for benign nonfunctioning kidneys: a single-center experience. Urology 57(4):644–649

    Article  PubMed  CAS  Google Scholar 

  10. Hemal AK, Gupta NP, Kumar R (2000) Comparison of retroperitoneoscopic nephrectomy with open surgery for tuberculous nonfunctioning kidneys. J Urol 164(1):32–35

    Article  PubMed  CAS  Google Scholar 

  11. Rassweiler J, Henkel T et al (1994) Retroperitoneal Laparoscopic nephrectomy and other procedures in the upper retroperitoneum using a balloon dissection technique. Eur Urol 25:229

    PubMed  CAS  Google Scholar 

  12. Mcdougall EM, Clayman RV, Fadden PT (1994) Retroperitoneoscopy: the Washington University Medical School experience. Urology 43(4):446–452

    Article  PubMed  CAS  Google Scholar 

  13. Webb DR, Redgrave N, Chan Y, Harewood LM (1993) Extraperitoneal laparoscopy: early experience, evaluation. Aust NZ J Surg 63:554

    Article  CAS  Google Scholar 

  14. Keeley FX Jr, Tolley DA (1999) Retroperitoneal laparoscopy. BJU Int 84:212–215

    Article  PubMed  Google Scholar 

  15. Hemal AK (1998) Re: laparoscopic nephrectomy via the retroperitoneal approach. J Urol 159:1992–1993

    Google Scholar 

  16. Gill IS, Grune MT, Munch LC (1996) Access technique for retroperitoneoscopy. J Urol 156:1120–1124

    Article  PubMed  CAS  Google Scholar 

  17. Hemal AK, Wadhwa SN, Kumar M, Gupta NP (1999) Transperitoneal and retroperitoneal laparoscopic nephrectomy for Giant Hydronephrosis. J Urol 162:35–39

    Article  PubMed  CAS  Google Scholar 

  18. Hemal AK, Kumar M (1999) Extracorporeal renal retraction: an adjunct during retroperitoneoscopic renal surgery. BJU Int 83:136–137

    Article  PubMed  CAS  Google Scholar 

  19. Rassweiler J, Fornara P, Weber M, Janet Schek G et al (1998) Laparoscopic nephrectomy: the experience of the laparoscopy working Group of the German urologic association. J Urol 160:18–21

    Article  PubMed  CAS  Google Scholar 

  20. Gupta NP, Agarwal AK, Sood S (1997) Tubercular pyelonephritic nonfunctioning kidney—another relative contraindication for laparoscopic nephrectomy: a case report. J Lap Adv Surg Tech 7(2):131–134

    Article  CAS  Google Scholar 

  21. Zhang X, Zheng T, Ma X, Li HZ, Li LC, Wang SG, Wu ZQ, Pan TJ, Ye ZQ (2005) Comparison of retroperitoneoscopic nephrectomy versus open approaches to nonfunctioning tuberculous kidneys: a report of 44 cases. J Urol 173(5):1586–1589

    Article  PubMed  Google Scholar 

  22. Mendoza D, Newman RC, Albala D et al (1996) Laparoscopic complications in markedly obese urological patients (a multi institutional review). Urology 48:562–566

    Article  PubMed  CAS  Google Scholar 

  23. Fazeli-Martin S, Gill IS, Hsu HS, Sung GT, Novick A (1999) Laparoscopic renal and adrenal surgery in obese patients: comparison to open surgery. J Urol 162:665–669

    Article  Google Scholar 

  24. Hemal AK, Mishra S (2010) Retroperitoneoscopic nephrectomy for pyonephrotic nonfunctioning kidney. Urology 75(3):585–588

    Article  PubMed  Google Scholar 

  25. Hemal AK, Goel A, Kumar M, Gupta NP (2001) Evaluation of laparoscopic retroperitoneal surgery in urinary stone disease. J Endourol 15(7):701–705

    Article  PubMed  CAS  Google Scholar 

  26. Yoshimura K, Takahara S, Kyakuno M, Yamaguchi S, Yoshioka T, Miyake O et al (2005) Retroperitoneoscopic living related-donor nephrectomy: clinical outcomes of 50 consecutive cases and comparison with open donor nephrectomy. J Endourol 19(7):808–812

    Article  PubMed  Google Scholar 

  27. Ma L, Ye J, Huang Y, Hou X, Zhao L, Wang G (2010) Retroperitoneoscopic live-donor nephrectomy: 5-year single-center experience in China. Int J Urol 17(2):158–162

    Article  PubMed  Google Scholar 

  28. Hemal AK, Kumar M, Wadhwa SN (1999) Retroperitoneoscopic nephrolympholysis and ureterolysis for management of intractable filarial chyluria. J Endourol 13(7):507–511

    Article  PubMed  CAS  Google Scholar 

  29. Zhang X, Zhu QG, Ma X, Zheng T, Li HZ, Zhang J, Fu B, Lang B, Xu K, Pan TJ (2005) Renal pedicle lymphatic disconnection for chyluria via retroperitoneoscopy and open surgery: report of 53 cases with followup. J Urol 174(5):1828–1831

    Article  PubMed  Google Scholar 

  30. Wyler SF, Sulser T, Ruszat R, Weltzien B, Forster TH, Provenzano M, Gasser TC, Bachmann A (2007) Intermediate-term results of retroperitoneoscopy-assisted cryotherapy for small renal tumours using multiple ultrathin cryoprobes. Eur Urol 51(4):971–979

    Article  PubMed  Google Scholar 

  31. Hemal AK, Talwar M, Wadhwa SN, Gupta NP (1999) Retroperitoneoscopic nephrectomy for benign diseases of the kidney: prospective nonrandomized comparison with open surgical nephrectomy. J Endourol 13(6):425–431

    Article  PubMed  CAS  Google Scholar 

  32. Gupta NP, Goel R, Hemal AK, Dogra PN, Seth A, Aron M, Kumar R, Ansari MS (2004) Should retroperitoneoscopic nephrectomy be the standard of care for benign nonfunctioning kidneys? An outcome analysis based on experience with 449 cases in a 5-year period. J Urol 172(4 Pt 1):1411–1413

    Google Scholar 

  33. Gupta NP, Hemal AK, Mishra S, Dogra PN, Kumar R (2008) Outcome of retroperitoneoscopic nephrectomy for benign nonfunctioning kidney: a single-center experience. J Endourol 22(4):693–698

    Article  PubMed  Google Scholar 

  34. Berglund RK, Gill IS, Babineau D, Desai M, Kaouk JH (2007) A prospective comparison of transperitoneal and retroperitoneal laparoscopic nephrectomy in the extremely obese patient. BJU Int 99(4):871–874

    Article  PubMed  Google Scholar 

  35. Cicco A, Salomon L, Hoznek H, Alame W, Saint F, Bralet MP, Antiphon P, Chopin DK, Abbou CC (2000) Carcinological risks and retroperitoneal laparoscopy. Eur Urol 38(5):606–612

    Article  PubMed  CAS  Google Scholar 

  36. Gill IS, Sung GT, Hobart MG, Savage SJ, Meraney AM, Schweizer DK, Klein EA, Novick AC (2000) Laparoscopic radical nephroureterectomy for upper tract transitional cell carcinoma: the Cleveland Clinic experience. J Urol 164(5):1513–1522

    Article  PubMed  CAS  Google Scholar 

  37. Desai MM, Strzempkowski B, Matin SF, Steinberg AP, Ng C, Meraney AM, Kaouk JH, Gill IS (2005) Prospective randomized comparison of transperitoneal versus retroperitoneal laparoscopic radical nephrectomy. J Urol 173(1):38–41

    Article  PubMed  Google Scholar 

  38. Nambirajan T, Jeschke S, Al-Zahrani H, Vrabec G, Leeb K, Janetschek G (2004) Prospective, randomized controlled study: transperitoneal laparoscopic versus retroperitoneoscopic radical nephrectomy. Urology 64(5):919–924

    Article  PubMed  Google Scholar 

  39. Hattori R, Yoshino Y, Gotoh M, Katoh M, Kamihira O, Ono Y (2006) Laparoscopic nephroureterectomy for transitional cell carcinoma of renal pelvis and ureter: Nagoya experience. Urology 67(4):701–705

    Article  PubMed  Google Scholar 

  40. Goel A, Hemal AK, Gupta NP (2002) Retroperitoneal laparoscopic radical nephrectomy and nephroureterectomy and comparison with open surgery. World J Urol 20(4):219–223

    PubMed  Google Scholar 

  41. Ng CS, Gill IS, Ramani AP, Steinberg AP, Spaliviero M, Abreu SC, Kaouk JH, Desai MM (2005) Transperitoneal versus retroperitoneal laparoscopic partial nephrectomy: patient selection and perioperative outcomes. J Urol 174(3):846–849

    Article  PubMed  Google Scholar 

  42. Permpongkosol S, Link RE, Su LM, Romero FR, Bagga HS, Pavlovich CP, Jarrett TW, Kavoussi LR (2007) Complications of 2, 775 urological laparoscopic procedures: 1993 to 2005. J Urol 177(2):580–585

    Article  PubMed  Google Scholar 

  43. Pareek G, Hedican SP, Gee JR, Bruskewitz RC, Nakada SY (2006) Meta-analysis of the complications of laparoscopic renal surgery: comparison of procedures and techniques. J Urol 175(4):1208–1213

    Article  PubMed  Google Scholar 

  44. Rassweiler J, Seeman O, Frede T et al (1998) Retroperitoneoscopy: experience with 200 cases. J Urol 160:1265–1269

    Article  PubMed  CAS  Google Scholar 

  45. Gill IS, Clayman RV, Albala DM et al (1998) Retroperitoneal and pelvic extraperitoneal laparoscopy: an international perspective. Urology 52(4):566–571

    Article  PubMed  CAS  Google Scholar 

  46. Quintela RS, Cotta LR, Neves MF, Abelha DL Jr, Tavora JE (2006) Retroperitoneoscopic nephrectomy in benign pathology. Int Braz J Urol 32(5):521–528

    Article  PubMed  Google Scholar 

  47. Fahlenkamp D, Rassweiler J, Fornara P, Frede T, Loening SA (1999) Complications of laparoscopic procedures in urology: experience with 2, 407 procedures at 4 German Centers. J Urol 162:765–771

    Article  PubMed  CAS  Google Scholar 

  48. Rosevear HM, Montgomery JS, Roberts WW, Wolf JS Jr (2006) Characterization and management of postoperative hemorrhage following upper retroperitoneal laparoscopic surgery. J Urol 176(4 Pt 1):1458–1462

    Google Scholar 

  49. Kumar A, Gupta NP, Hemal AK (2009) A single institution experience of 141 cases of laparoscopic radical nephrectomy with cost-reductive measures. J Endourol 23(3):445–449

    Article  PubMed  Google Scholar 

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Acknowledgments

We would like to recognize the colleagues, fellows and residents, who have contributed to the development of retroperitoneoscopic surgery over the years and shaped it to its present form.

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Authors and Affiliations

  1. Department of Urology, All India Institute of Medical Sciences, New Delhi, India

    Rajeev Kumar

  2. Department of Urology, Institute of Regenerative Medicine, Robotics and Minimally Invasive Surgery, Baptist Medical Center, Wake Forest University Health Sciences, Medical Center Boulevard, Winston-Salem, NC, 27157-1094, USA

    Ashok K. Hemal

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  1. Rajeev Kumar
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  2. Ashok K. Hemal
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Correspondence to Ashok K. Hemal.

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Kumar, R., Hemal, A.K. Retroperitoneal renal laparoscopy. Int Urol Nephrol 44, 81–89 (2012). https://doi.org/10.1007/s11255-010-9882-9

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