Extraperitoneal Laparoscopic Surgery using Balloon Dissector

Ryu, Ji Kan; Park, Dong Soo; Yang, Seung Cheol

Abstract

The use of conventional laparoscopic technique in surgeries of kidney, ureter, and bladder requires unnecessary manipulations in the peritoneal cavity. Despite such disadvantages, the inevitable advantages of laparoscopic surgery such as reduced wound pain and scar along with reduced hospital stay, and the difficulties in securing sufficient operative space in retroperitoneum, the urologists had to resort to the conventional laparoscopic surgeries. Recently to avoid unnecessary intraperitoneal manipulations thereby reducing postoperative complications such as bowel injury and adhesion, balloon dissectors were introduced. We have performed 9 renal cystectomy in symptomatic or obstructive renal cysts, and 6 bladder neck suspensions(Burch) in females with stress urinary incontinence. Mean operative time and hospital stay were 120 minutes(range: 90-210 minutes) and 3 days(range: 2-4 days) for bladder neck suspensions and 70 minutes(range: 45-120 minutes) and 2 days(range: 1-3 days) for renal cystectomy, respectively Few problems were encountered during pelvic procedures, but for renal cystectomy it was difficult to secure operative field in case of peritoneal perforations. The need for development or improvement of appropriate operative equipments required for these cases.