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    Our Initial Experience with Retroperitoneoscopy
    (Galenos Yayincilik, 2009) Tok, Adem; Tepeler, Abdulkadir; Aktoz, Tevfik; Kaba, Mehmet; Akcay, Muzaffer; Binbay, Murat; Tefekli, Ahmet Hamdi
    Current indications of retropentoneoscopy have been extended to oncologic operations and complex reconstructive procedures. We present our experience vvith retropentoneoscopy m 128 cases. Between 2003 and 2007 Pk retropentoneosopic procedures (61 nephrectomies 4 radical nephrectorny, 43 renal cyst resections, 1 heminephrectomy. 5 pyeloplasties, 7 unreterolithotomies. 2 pyelolithotomies. 3 partial nephrectomies. 1 adrenelectomy 1 nephrolithotomy) were performed in 128 patients (78 male, 50 female) with a mean age of 44.1 +/- 14.5 (range: 12-75`) years at our department. A canal was created through petit triangle, peritoneum was pushed medially try index finger and dissection of the retroperitoneal sPace was enabled by the balloon distension system. We classified 43 procedures (33%) as simple (cyst resctions), 81 (64%) as difficult (adrenalectomy, nephrectomy) and 4 (3%) as very difficult (partial nephrectomy, heminephrectomy). The mean operation time was 108 +/- 23.6 (range: 55-270) minutes depending on the difficulty of the procedure. The mean hospitalization period was 3.6 +/- 1.5 (range: 1-10) days. Major complications were not observed except vena cava inferior injury in one patient. Minor complications including fever (n=4) port-site infection (n: 3) were encountered in 5.4% (n=7). Blood transfusion was required in 4 cases. Open conversion was indicated in 3 cases due to xantagranulomatosis pyelonephritis (n=1). vena cava injury (n=1) and technical difficulties (n=1). Retroperitoneoscopy has proven to be an axcellent approach with certain advantages such as early control of renal hilurn, minimal risk of abdominal complication and feasibility in cases of previous abdominal surgery.

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