Access for retroperitoneoscopic surgeryRetroperitoneoscopic surgery is used for a variety of renal and adrenal procedures in the paediatric population. This can be a challenging procedure but has advantages over open and transperitoneal laparoscopic approaches. This VideoBank article aims to aid the surgeon in gaining safe and efficient access for retroperitoneal surgery by demonstrating key steps including patient positioning and optimal trocar placement.
Retroperitoneoscopic lower pole heminephrectomyRetroperitoneoscopic heminephrectomy is a challenging procedure but with advantages over open and transperitoneal laparoscopic approaches. Lower pole heminephrectomy is less commonly undertaken compared with the upper pole.s
Laparoscopic ureterocalicostomy in children: The technique and feasibilityUreterocalicostomy is a salvage technique commonly used for failed pyeloplasties; it has also been reported as a primary procedure in ureteropelvic junction obstruction (UPJO). This video describes the technique of laparoscopic ureterocalicostomy for primary UPJO in a child with a malrotated kidney and parenchymal thinning. A 13-year-old girl with symptomatic UPJO was found to have a malrotated kidney with a high posterior insertion of the ureter. A laparoscopic dependent ureterocalicostomy over a double-J stent was performed.
Retroperitoneoscopic heminephrectomyRetroperitoneoscopic heminephrectomy has multiple potential benefits in both infants and children. This article reviewed technical aspects of the procedure, and provided illustrations and an operative video demonstration. The vital first step is a ‘critical view’ of the collecting system/vascular supply of both upper/lower moieties. Dividing the lateral renal attachments later in the dissection allows passive retraction of the hilum, facilitating this dissection.
Surgical technique: Retroperitoneoscopic approach for adrenal masses in childrenLaparoscopic adrenalectomy is considered to be the standard of care for the surgical excision of adrenal masses. The transperitoneal laparoscopic and retroperitoneoscopic approaches are described. Both are safe and as effective as open adrenalectomy, with the added benefit of the minimally invasive approach. It can be utilized for patients requiring surgery for a phaeochromocytoma, adrenal adenoma, adrenal adenocarcinoma, Cushing's syndrome, neuroblastoma, and an incidentaloma. Relative contraindications include previous surgery of the liver or kidney, large tumours (>8–10 cm in diameter) or coagulation disorders.