ESPU Congress 2018 - Abstract Book

214 29 th CONGRESS OF THE ESPU MATERIAL AND METHODS Optical access technique was used for prone retroperitoneoscopic upper renal tract surgeries and data was prospectively collected from June 2015 to March 2017. A 5 mm bladeless optical tip trocar with zero degree short length telescope was used to access the retroperitoneum under direct endoscopic vision with child in prone position. The trocar is advanced by rotating movement with the telescope within it, visualising its passage through Latissimus dorsi, Serratus posterior inferior muscles and thoracodorsal fascia. The retroperitoneal space is identified beyond the fascial layer by presence of fat and fine radiating blood vessels. At this point CO2 is insufflated at 15 mmHg and blunt dissection is carried out with the telescope tip to create the retroperitoneal working space and then other ports are put under vison to complete the surgery. RESULTS 20 renal surgeries (14-nephrectomies, 6-nephroureterectomy) were performed after gaining access by this technique. Ages ranged from 3 months to 15 years, kidney sizes 1.6 to 15 cm. The average time for access and establishing the retroperitoneal working space was 5-minutes (range 4–7). Safe access was successfully achieved in all to complete the surgery successfully. A snug fit was achieved at port sites avoiding the problems of gas leak or subcutaneous emphysema. CONCLUSIONS Retroperitoneal access could be achieved safely in a controlled manner, under vision and is repro- ducible as shown in the video. Snug fit achieved at port sites, avoiding problems of gas leak and air emphysema.