Extraperitoneal laparoscopy: early experience and evaluation.
This paper evaluates the use of various balloon dilators in the flank, iliac fossa and retro-pubic regions to create extraperitoneal spaces for subsequent extraperitoneal laparoscopy. Eight patients were investigated, three undergoing pelvic surgery, four renal surgery (two nephrectomies) and one laparoscopic ureterolithotomy. Extraperitoneal balloon dilatation was simple, safe and easy and provided large tamponaded bloodless cavities and excellent vision. Port access was slightly restricted by the lateral peritoneal reflections and bony prominences of the thorax and pelvis. This approach for laparoscopy is safe, simple and deserving of further evaluation.
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