Objective To evaluate the technique and clinical effect of retroperitoneoscopic adrenalectomy for pheochromocytoma.Methods A total of 78 patients received roperitoneoscopic adrenalectomy for pheochromocytoma from March 2006 to June 2008.Retroperitoneal space was enlarged routinely with patient in lateral decubitus position.After adequate retroperitoneal space was created,three relatively bloodless planes were orderly entered for exposure and separation of the adrenal gland and tumor.The first dissection plane was between the psoas and posterior Gerota's fascia.The subsequent dissections were proceeded in the plane between anterior Gerota's fascia and perirenal fat.The third dissection plane was between the adrenal gland and upper pole of kidney.The tumor and parts of adrenal glands were then excised.Results A1l operations were successful.The mean operative time and estimated blood loss were 145?53min and 100?49 ml,with no blood transfusion,and no conversion to open surgery.The mean postoperative analgesic(pethidine) consumption was 57?38mg.Time for oral intake of food and ambulation after operation were 1.6?0.5d and 1.5?0.3d,respectively.The mean postoperative hospital stay was 5.8?1.9d.No major intraoperative complications occurred.Conspicuous fluctuation of blood pressure(≥50mmHg) was observed in 49 patients during operation.56 patients were followed up,and no recurrence or metastasis of the tumor was found during a follow-up period of 12.3?8.7 months in average(range from 2 to 26 months).Conclusions With adequate preparations,retroperitoneoscopic adrenalectomy for pheochromocytoma(≤6cm) is a safe and effective procedure in the hand of an exparienced surgeon since it gives a clear operative field,adequate space for manipulation,distinct anatomic landmark and minimal agitation.

Objective To introduce the technique and evaluate the clinical effect of retroperito-neoscopic anatomical radical nephrectomy. Methods One hundred and sixty-eight patients under-went retroperitoneoscopic anatomical radical nephrectomies. The average tumor size was 4.7 cm (ran-ging from 2.0-6.9 era) in diameter. There were 87 tumors in the left kidney and 81 tumors in right kidney. Ninety-two eases were in cli.nieal stage T1a. N0 M0 and 76 in T1b N0 M0. Retroperitoneal space was created routinely at lateral decubitus position. Four relatively bloodless planes were orderly entered for exposure and separation of the kidney outside Gerota's fascia. The first dissection plane was be-tween the psoas and posterior Gerota's fascia. The renal pedicle was found in this plane. The following dissections proceeded in the plane between posterior Gerota's fascia and fusion fascia. The third dissec-tion plane was between adrenal gland and the upper pole of kidney or between the adrenal gland and di-aphragma. The fourth dissection plane was in the bottom of Gerota's fascia. Results All operations were successfully completed. The mean operative time was 138:J:46 min and estimated blood loss was 90±30 ml. The average day of resuming oral intake was 1.3 d and time of ambulation was 1.2 d. The mean postoperative hospital stay was 5.8 d. Peritoneum injuries happened in 14 patients. Omalgia oc-curred in 18 patients and disappeared 2 d after operation. One hundred and twenty-three patients were followed up, they all survived during the average follow-up of 8 months (ranging from 6-18 months);, .Conclusions Retroperitoneoscopie anatomical radical nephrectomy is a safe and effective procedure. It can decrease operation time, blood loss and complication rate remarkably. It is a good option for patients needing radical nephrectomy.