Endoscopic retroperitoneal nephrectomy

J. G. Borer, A. Atala

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Purpose: We describe modifications of the retroperitoneoscopic approach to the kidney, including the use of 2-mm instrumentation and prone positioning. Patients and Methods: Twenty-one children (13 girls, 8 boys; mean age 2.1 years) have undergone retroperitoneoscopic dissection in the prone position. An inflatable dissecting device was inserted into the retroperitoneum through a small incision at the lateral border of the sacrospinalis muscle, just below the costovertebral angle. After inflation, the dissecting device was replaced with a 5-mm cannula, the pneumoretroperitoneum was maintained with CO2 insufflation, and two 2-mm trocars were placed with endoscopic guidance. Dissection was performed using 2-mm instrumentation, and the specimen was extracted through the site of the largest port. Results: The children underwent nephrectomy, heminephrectomy, or total nephro-ureterectomy for chronic pyelonephritis with minimal function, reflux or obstruction with nonfunctioning kidney or moiety, multicystic dysplastic kidney, upper pole dysplastic moiety with associated ureterocele, or dysplastic kidney with a vaginal ectopic ureter. The mean operative time for the retroperitoneoscopic dissection was 142 minutes with an estimated blood loss of <15 mL. Conclusions: Several modifications to the retroperitoneal approach, including the use of prone positioning and 2-mm instrumentation, provide unobstructed viewing of the kidney and renal hilum and facilitate dissection in a small working space. These modifications may improve the safety and efficacy of this technique in children.

Original languageEnglish
Pages (from-to)229-236
Number of pages8
JournalPediatric Endosurgery and Innovative Techniques
Volume4
Issue number3
StatePublished - Oct 24 2000
Externally publishedYes

Fingerprint

Nephrectomy
Dissection
Kidney
Retropneumoperitoneum
Multicystic Dysplastic Kidney
Ureterocele
Equipment and Supplies
Prone Position
Insufflation
Pyelonephritis
Economic Inflation
Ureter
Operative Time
Surgical Instruments
Safety
Muscles

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Endoscopic retroperitoneal nephrectomy. / Borer, J. G.; Atala, A.

In: Pediatric Endosurgery and Innovative Techniques, Vol. 4, No. 3, 24.10.2000, p. 229-236.

Research output: Contribution to journalArticle

Borer, JG & Atala, A 2000, 'Endoscopic retroperitoneal nephrectomy', Pediatric Endosurgery and Innovative Techniques, vol. 4, no. 3, pp. 229-236.
Borer, J. G. ; Atala, A. / Endoscopic retroperitoneal nephrectomy. In: Pediatric Endosurgery and Innovative Techniques. 2000 ; Vol. 4, No. 3. pp. 229-236.
@article{f44e9a056e8942289b2477ffbba50f52,
title = "Endoscopic retroperitoneal nephrectomy",
abstract = "Purpose: We describe modifications of the retroperitoneoscopic approach to the kidney, including the use of 2-mm instrumentation and prone positioning. Patients and Methods: Twenty-one children (13 girls, 8 boys; mean age 2.1 years) have undergone retroperitoneoscopic dissection in the prone position. An inflatable dissecting device was inserted into the retroperitoneum through a small incision at the lateral border of the sacrospinalis muscle, just below the costovertebral angle. After inflation, the dissecting device was replaced with a 5-mm cannula, the pneumoretroperitoneum was maintained with CO2 insufflation, and two 2-mm trocars were placed with endoscopic guidance. Dissection was performed using 2-mm instrumentation, and the specimen was extracted through the site of the largest port. Results: The children underwent nephrectomy, heminephrectomy, or total nephro-ureterectomy for chronic pyelonephritis with minimal function, reflux or obstruction with nonfunctioning kidney or moiety, multicystic dysplastic kidney, upper pole dysplastic moiety with associated ureterocele, or dysplastic kidney with a vaginal ectopic ureter. The mean operative time for the retroperitoneoscopic dissection was 142 minutes with an estimated blood loss of <15 mL. Conclusions: Several modifications to the retroperitoneal approach, including the use of prone positioning and 2-mm instrumentation, provide unobstructed viewing of the kidney and renal hilum and facilitate dissection in a small working space. These modifications may improve the safety and efficacy of this technique in children.",
author = "Borer, {J. G.} and A. Atala",
year = "2000",
month = "10",
day = "24",
language = "English",
volume = "4",
pages = "229--236",
journal = "Pediatric Endosurgery and Innovative Techniques",
issn = "1092-6410",
publisher = "Mary Ann Liebert Inc.",
number = "3",

}

TY - JOUR

T1 - Endoscopic retroperitoneal nephrectomy

AU - Borer, J. G.

AU - Atala, A.

PY - 2000/10/24

Y1 - 2000/10/24

N2 - Purpose: We describe modifications of the retroperitoneoscopic approach to the kidney, including the use of 2-mm instrumentation and prone positioning. Patients and Methods: Twenty-one children (13 girls, 8 boys; mean age 2.1 years) have undergone retroperitoneoscopic dissection in the prone position. An inflatable dissecting device was inserted into the retroperitoneum through a small incision at the lateral border of the sacrospinalis muscle, just below the costovertebral angle. After inflation, the dissecting device was replaced with a 5-mm cannula, the pneumoretroperitoneum was maintained with CO2 insufflation, and two 2-mm trocars were placed with endoscopic guidance. Dissection was performed using 2-mm instrumentation, and the specimen was extracted through the site of the largest port. Results: The children underwent nephrectomy, heminephrectomy, or total nephro-ureterectomy for chronic pyelonephritis with minimal function, reflux or obstruction with nonfunctioning kidney or moiety, multicystic dysplastic kidney, upper pole dysplastic moiety with associated ureterocele, or dysplastic kidney with a vaginal ectopic ureter. The mean operative time for the retroperitoneoscopic dissection was 142 minutes with an estimated blood loss of <15 mL. Conclusions: Several modifications to the retroperitoneal approach, including the use of prone positioning and 2-mm instrumentation, provide unobstructed viewing of the kidney and renal hilum and facilitate dissection in a small working space. These modifications may improve the safety and efficacy of this technique in children.

AB - Purpose: We describe modifications of the retroperitoneoscopic approach to the kidney, including the use of 2-mm instrumentation and prone positioning. Patients and Methods: Twenty-one children (13 girls, 8 boys; mean age 2.1 years) have undergone retroperitoneoscopic dissection in the prone position. An inflatable dissecting device was inserted into the retroperitoneum through a small incision at the lateral border of the sacrospinalis muscle, just below the costovertebral angle. After inflation, the dissecting device was replaced with a 5-mm cannula, the pneumoretroperitoneum was maintained with CO2 insufflation, and two 2-mm trocars were placed with endoscopic guidance. Dissection was performed using 2-mm instrumentation, and the specimen was extracted through the site of the largest port. Results: The children underwent nephrectomy, heminephrectomy, or total nephro-ureterectomy for chronic pyelonephritis with minimal function, reflux or obstruction with nonfunctioning kidney or moiety, multicystic dysplastic kidney, upper pole dysplastic moiety with associated ureterocele, or dysplastic kidney with a vaginal ectopic ureter. The mean operative time for the retroperitoneoscopic dissection was 142 minutes with an estimated blood loss of <15 mL. Conclusions: Several modifications to the retroperitoneal approach, including the use of prone positioning and 2-mm instrumentation, provide unobstructed viewing of the kidney and renal hilum and facilitate dissection in a small working space. These modifications may improve the safety and efficacy of this technique in children.

UR - http://www.scopus.com/inward/record.url?scp=0033779705&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0033779705&partnerID=8YFLogxK

M3 - Article

AN - SCOPUS:0033779705

VL - 4

SP - 229

EP - 236

JO - Pediatric Endosurgery and Innovative Techniques

JF - Pediatric Endosurgery and Innovative Techniques

SN - 1092-6410

IS - 3

ER -