Original Article

 

Authors: Kr. Yanev, M. Georgiev, D. Ormanov, Pl. Dimitrov, V. Vassilev, S. Kirilov, P. Simeonov, P. Panchev
Department of urology, “Alexandrovska” University hospital, Sofia

Address for correspondence: Kr.Yanev, Department of urology, “Aleksandrovska” University hospital, Sofia 

 

Keywords: retroperitoneoscopic operations, ESWL, pyeloplasty, ureterolithotomy, pyelolithotomy

 

Abstract

Retroperitoneoscopic approach is gradually becoming the method of choice in many urologic diseases, displacing the classical lumbotomy. In this article we analyse and present the first cases of urological retroperitoneoscopic operations performed in the Department of Urology at the „Aleksandrovska” University Hospital. For the period from May 2006 to March 2009 37 operations have been performed: 27 retroperitoneoscopic decortications of renal cysts with a different location (from 6 to 15 centimeters in diameter), 5 pyeloplasties (in 3 cases by Fenger method and 2 cases with Y-V pyeloplasty), 4 ureterolithotomies and 1 pyelolithotomy.
The mean operative time in retroperitoneoscopic decortications of renal cysts was 49.62 minutes (15 to 95 minutes), and in pyeloplasties, ureterolithotomies and pyelolithotomies, mean operative time was 88.00 minutes (65 to 150 minutes).
The average pararenal drainage secretion was 138ml for 24 hours (from 50ml to 150ml). The average blood loss was 86ml (from 50ml to 120ml). In one case conversion was required because of technical problems and little experience of the team. Postoperatively in 5 cases (13.51%) we observed subcutaneous emphysema.
All the surgical principles for anatomical dissection and plastic reconstruction which are applicable in open operations were applied in retroperitoneoscopic urological operations.