Feasibility And Outcomes Of Retroperitoneal Laparoscopic Re-operation After Previous Ipsilateral Retroperitoneal Surgery

Objective To investigate the feasibility of re-operation in the nephron region by retroperitoneal laparoscopy in patients with previous ipsilateral retroperitoneal surgery. Methods 7 patients who underwent retroperitoneal laparoscopy for a second operation from June 2012 to June 2015 in our hospital,were analyzed retrospectively. All the patients had received an ipsilateral operation by open or retroperitoneal laparoscopic approaches. Among the patients, two were diagnosed with recurrent retroperitoneal tumor,one had ipsilateral recurrent adrenal adenoma,one had adrenal cystic lesions,one had mutiple renal cyst, one had renal pelvic urothelial carcinoma, one had ureter-pelvic junction obstruction.. The interval between the two operations ranged from1.0 to 29 years. The intraoperative and postoperative clinical data were observed. Results The procedure was completed in 6 patients within 40-195 min. The intraoperative blood loss ranged from 10 to 120 ml.One case needed operative conversion to open surgery because of dense adhesion. Conclusion Treating patients by retroperitoneal laparoscopy after previous retroperitoneal surgery(renal or adrenal) is technically challenging, because adhesions may distort tissue planes and alter the normal location of critical structures in an unpredictable fashion. Re-operation in the nephron region is feasible in properly selected cases with skilled and experienced hands.