Retroperitoneoscopic uretero-cutanostomy — our method of creating a pneumoretroperitoneum

SummaryRetroperitoneoscopic procedures were already being performed in the late 1970s. The clinical breakthrough of retroperitoneoscopy, however, came in 1992 with the balloon-dissecting technique of Gaur, facilitated by the experience gained with transperitoneal laparoscopic procedures in the upper retroperitoneum. A 60 year old woman with infiltrative bladder cancer and right-sided obstructive uropathy was a high risk patient for an open surgical operation. Until now, our retroperitoneoscopic procedures were usually performed by hydraulic video-optically controlled balloon dissection. With this patient, for the first time we created a pneumoretroperitoneum using an optical trocar-Visiport. In this way we entered the retroperitoneum by visualising all layers of the abdominal wall. Once inside the retroperitoneum we created a work space by blunt and sharp dissection under optical control, avoiding blood vessels. The ureter, which was dilated by infiltrative bladder carcinoma, was easily identified, clippe...