Retroperitoneoscopic surgery — technique, indications and first experience

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Abstract
Although retroperitoneoscopic procedures were already being performed in the late seventies, it was the balloon-dissecting technique introduced by Gaur, together with the progressive experience in trans-peritoneal laparoscopic procedures in the upper retroperitoneum, that initiated the clinical breakthrough of retroperitoneoscopy. We modified the balloon-dissecting technique into a hydraulic, video-optically controlled balloon dissection of the retroperitoneal space. This technique permitted successful, extensive laparoscopic surgery on the kidney and ureter. We summarize the history of retroperitoneoscopy, the different methods of gaining access to the retroperitoneum and the types of surgery made possible by this new approach, along with our experience in our first 41 cases.