Controlled Balloon Dilatation of the Extraperitoneal Space for Laparoscopic Urologic Surgery
- 1 August 1994
- journal article
- Published by Mary Ann Liebert Inc in Journal of Laparoendoscopic Surgery
- Vol. 4 (4), 247-251
- https://doi.org/10.1089/lps.1994.4.247
Abstract
Laparoscopic urologic surgery has become increasingly more popular, with the majority of procedures and techniques that have been described based on intraperitoneal experience and anatomic considerations. Urologic surgery, traditionally confined mostly to the extraperitoneal space, has followed these intraperitoneal descriptions when undertaken laparoscopically. Our experience of controlled, laparoscopically monitored dilatation of the extraperitoneal space using a new trocar-mounted balloon dissector can create a working space in a surgical environment familiar to traditional open urologic surgery. We report our initial experience with the preperitoneal distention balloon in 15 patients, emphasizing the technique of extraperitoneal access and the laparoscopic visualization of anatomy relevant to pelvic lymph node dissection, varicocele ligation, nephropexy, and renal biopsy. In this early experience, laparoscopic pelvic lymph node dissection was performed successfully in 7 of 11 patients and in all other patients undergoing the retroperitoneal procedures. Patients with a prior history of hernia repair or appendectomy do not appear to be suitable to this approach when used for pelvic lymphadenectomy. The trocar-mounted balloon device allows direct visualization and control of the dissection process. Avoiding the transperitoneal approach may eliminate many of the complications associated with the transperitoneal access and procedure completion. We conclude that the extraperitoneal technique using this device merits further investigation and more widespread application in the laparoscopic approach to conventional extraperitoneal urologic procedures.Keywords
This publication has 7 references indexed in Scilit:
- Screening for Occult Nodal Metastasis in Localized Carcinoma of the ProstateJournal of Urology, 1993
- Complications of Laparoscopic Pelvic Lymph Node DissectionJournal of Urology, 1993
- Extraperitoneal Endoscopic Pelvic Lymph Node Dissection vs. Laparoscopic Lymph Node Dissection in the Staging of Prostatic and Bladder CarcinomaJournal of Laparoendoscopic Surgery, 1992
- LAPAROSCOPIC PELVIC LYMPHADENECTOMY FOR PROSTATIC ADENOCARCINOMAUrologic Clinics of North America, 1992
- Laparoscopic Varix LigationJournal of Urology, 1992
- Transperitoneal Endosurgical Lymphadenectomy in Patients with Localized Prostate CancerJournal of Urology, 1991
- Surgical Staging of Prostatic Cancer: Transperitoneal Versus Extraperitoneal LymphadenectomyJournal of Urology, 1977