Modified technique for dissection of working space in retroperitoneal laparoscopic surgery: A step-by-step guide

Abstract

Objectives

This work aims to describe with a step-by-step guide for modified dissection technique to create a retroperitoneal working space during laparoscopic surgery.

Materials and Methods

From May 2021 to December 2022, we performed a modified dissection technique to create a retroperitoneal working space prior retroperitoneal laparoscopic surgery in 47 patients. The retroperitoneum is initially accessed by puncturing the trocar through a 10-mm transverse skin incision in the midaxillary line. Under endoscopic monitoring, the tip of the trocar is adjusted to a relative avascular layer between the transversus abdominis muscle and the pararenal fat. Laparoscopic dissection is performed to develop until the working space is fully established.

Results

In all cases, a satisfactory retroperitoneal space was created for surgery. No dissection-related complications were noted within a median follow-up period of 9 (IQR:7,15) months.

Conclusions

Modified retroperitoneal dissection with laparoscopy is a safe, simple, effective, and minimally invasive technique. It provides an adequate working space and an excellent view without obvious bleeding.