Publication:

Cost cutting: laparoscopic extraperetoneal and retroperitoneal approach – economical way

Background Extraperitoneal and retroperitoneal approaches have become popular among laparoscopic surgeons. The limited space makes the dissection more difficult. Although experienced surgeons create this initial working space under vision, the beginners find it easy to do so by using balloon dissectors (BDs). But the cost of disposable items is one of the limiting factors in the popularity of these operations. Therefore, indigenously designed BDs are popular. By using a homemade balloon, non-disposable ports and non tackering the mesh we have been able to reduce the cost considerably, and were able to create large working spaces with good hemostasis without any complications and conversion to open. We would like to present our technique of making the balloon.

Methods Between January 2014 and September 2015, consecutive 50 cases of totally extra-peritoneal repair (TEP) and 20 cases of laparoscopic retroperitoneal pyelolithotomy (LRPL) were done using a homemade balloon for creating the extra peritoneal and retroperitoneal spaces respectively.

Results We succeeded in creating the extraperitoneal space in all patients with the help of this balloon without any complications and conversion to open. There was no leak and bursting of the balloon.

Conclusions It is cheap, strong, sterile and readily available material for making the balloon for creating the extra peritoneal and retroperitoneal spaces respectively in the laparoscopic surgeries.