Experience with retroperitoneoscopy in pediatric surgical oncology
- 13 April 2011
- journal article
- Published by Springer Science and Business Media LLC in Surgical Endoscopy
- Vol. 25 (8), 2748-2755
- https://doi.org/10.1007/s00464-011-1583-7
Abstract
Retroperitoneoscopy (RS) has been successfully introduced in adult oncology for diagnostic procedures, staging, and surgical treatment. Its value for children has rarely been reported. This report describes the authors’ experience using RS in the diagnosis and staging of cancer for children and adolescents. All RS procedures performed at the authors’ institution between 2004 and 2010 were reviewed. The authors’ operative technique entails a 10- to 12-mm flank incision followed by finger and balloon dissection of the retroperitoneal areolar tissue, with carbon dioxide (CO2) insufflation used to push the peritoneal lining medially. One to two additional working ports are placed above the iliac rim and below the costal margin. In cases of peritoneal tear with leakage of CO2 and progressive retroperitoneal impingement, a Veress needle is placed in the umbilicus for pressure release. This review included 16 patients with a median age of 16.4 years (range, 4.4–29.8 years) who underwent RS for lymph node sampling (9 cases), diagnostic biopsy (6 cases), or resection of a metastatic nodule (1 case). Four complications were encountered (3 conversions to open surgery and 1 self-limited gross hematuria). The mean operative time was 123.3 ± 33.5 min. The patients required 1.1 ± 0.8 days of intravenous analgesia on the average. The mean hospital stay was 1.7 ± 0.6 days. The authors believe that RS is a safe surgical technique for access to the retroperitoneum in pediatric patients. In cases of a peritoneal tear, placement of a Veress needle in the umbilicus effectively prevents conversion to open surgery. Retroperitoneoscopy should be considered for children who need biopsies, lymph node dissections, or resections of primary tumors in the retroperitoneum.Keywords
This publication has 45 references indexed in Scilit:
- Usefulness of extraperitoneal laparoscopic paraaortic lymphadenectomy for lymph node recurrence in gynecologic malignancyActa Obstetricia et Gynecologica Scandinavica, 2008
- Pelvic lymph node dissection via a lateral extraperitoneal approach: Description of a techniqueGynecologic Oncology, 2008
- Laparoscopic extraperitoneal paraaortic lymphadenectomy in patients with locally advanced cervical cancerGynecologic Oncology, 2007
- Retroperitoneoscopic Pyeloplasty for Ureteropelvic Junction ObstructionJournal of Endourology, 2004
- Use of Foley's catheter to gain access for retroperitoneoscopyAnz Journal of Surgery, 2004
- Current indications for laparoscopy and retroperitoneoscopy in pediatric urologySurgical Endoscopy, 2004
- Extirpation of mass-screened adrenal neuroblastomas by retroperitoneoscopySurgical Endoscopy, 2003
- Retroperitoneoscopic Approach to the Adrenal Glands and Retroperitoneal Tumours in Children: Where Do We Stand?European Journal of Pediatric Surgery, 2003
- RETROPERITONEAL LAPAROSCOPIC ACCESS IN CHILDREN USING A DIRECT VISION TECHNIQUEJournal of Urology, 2001
- Controlled Balloon Dilatation of the Extraperitoneal Space for Laparoscopic Urologic SurgeryJournal of Laparoendoscopic Surgery, 1994