Laparoscopic kidney surgery is a relatively new addition to the minimally invasive armamentarium of urologists. The kidney may be approached using a transperitoneal or retroperitoneal access. Each approach may have unique indications. These indications are becoming defined as experience with laparoscopic urology increases. Also, both approaches are associated with complications that are specific to that access technique. This chapter outlines complications associated with laparoscopic kidney surgery under the two broad headings of transperitoneal and retroperitoneal access. The discussion is focused on laparoscopic nephrectomy, although other operative renal procedures are presented in the retroperitoneal section.
The key element in laparoscopic surgery is the use of a laparoscope: a telescopic rod lens system that is usually connected to a video camera. Also attached is a fiber optic cable system connected to a light source to illuminate the operative field. The abdomen is usually insufflated with carbon dioxide gas to create a working and viewing space. The gas used is CO2, as it is common to the human body and can be removed by the respiratory system if it absorbs through tissue.
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