【摘要】 目的　探讨不同后腹膜腔隙扩张法腹腔镜技术在泌尿外科手术中的应用。方法　对 2 0 0 1年至今开展的共 12 0例后腹腔镜泌尿外科手术进行分析 ,本组患者全部采用曲卡直接穿刺法建立通道 ,后腹膜腔分别采用水囊扩张法、观察镜直接分离法或二者联合应用建立后腹膜腔气腹 ,用后腹腔镜技术完成所有病例。结果　除1例因后腹膜腔制备失败中转开放手术外 ,其余 119例手术均获成功 ,手术时间肾囊肿 2 0～ 12 0minutes ,肾上腺4 5～ 14 0minutes ,1例肾切除 2 10minutes ;失血量 2 0～ 10 0ml,平均 5 0ml。结论　熟练操作技术 ,术中灵活采用几种后腹膜腔隙建立法 ,使手术野得以充分暴露是手术成功的关键。本方法是一种微创、安全、出血少、术后恢复快 ,并能成为肾脏和肾上腺疾病的首选方法更多还原

【Abstract】 evaluate different methods for creating a retroperitoneum space in posterior retroperitoneoscopy as a new minimally invasive technique for urologic diseases.Method We presented 120 cases from the year 2001 using three different retroperitoneum dilation methods for laparoscopic surgery in urologic diseases.After trocar insertion we used a balloon dilator to create a retroperitoneal space, or to create the space directly with the tip of the laparoscope. When the retroperitoneal fat was rich, we also combined the two methods mentioned above to create a satisfactory retroperitoneal space.120 cases of retroperitoneal laparoscopy were applied for 87 cases of renal cysts, 32 adrenal tumors and one nephnectomy.Result The procedure was successful in the 119/120 cases, the operation time was 20～120 minutes for renal cystic diseases,45～140 minutes for adrenal tumors and 210 minutes for one nephnectomy; there was no need for blood transfusion with the blood loss range from 20 to 100ml. No complications were occurred during or postoperatively.Conclusion Combination of the three different methods to create a pneumoretroperitonium has been proved to be a procedure with microinvasive, safety, less bleeding, smooth postoperative recovery and less complications. It could be the first choice for most adrenal adenoma and parts of the renal diseases.更多还原