Retroperitoneal laparoscopic access in children using a direct vision technique

S. Micali, P. Caione, G. Virgili, N. Capozza, M. Scarfini, F. Micali

Research output: Contribution to journalArticle


Purpose: Retroperitoneal procedures were initiated in 1992 by balloon dissection of the retroperitoneum. More recently a new type of retroperitoneal access has been obtained by directly entering the retroperitoneum using the Visiport visual trocar.* We present our initial experience with direct visual access to the retroperitoneum in the pediatric population. Materials and Methods: A total of 31 children underwent retroperitoneal laparoscopy, including renal biopsy in 22, varicocelectomy in 5, renal cyst ablation in 3 and pyelolithotomy for a staghorn stone in 1. Patients were placed in the full flank position. A maximum of 3 ports was used and the initial trocar was placed under direct vision. The laparoscope was then used to dissect bluntly a working space in the retroperitoneum. Results: All procedures were successful. Blood loss was minimal. Operative time was 4 hours for pyelolithotomy and less than I for the other procedures. Mean hospital stay was 1.5 days and all patients returned to normal activity at a mean of 6 days. Two minor complications developed. The peritoneum was inadvertently entered in 1 case, in which no further treatment was necessary and convalescence was uneventful and short. In another case severe arrhythmia developed, resulting in an aborted procedure. Conclusions: This technique is simple, safe and does not require extensive laparoscopic experience.

Original languageEnglish
Pages (from-to)1229-1232
Number of pages4
JournalJournal of Urology
Issue number4
Publication statusPublished - 2001


  • Laparoscopy
  • Retroperitoneal space

ASJC Scopus subject areas

  • Urology

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