Retroperitoneoscopy versus laparoscopy in piglets: Ventilatory and thermic repercussions

Background/Purpose: Endoscopic surgery of the retroperitoneal space in children is developing, During preliminary clinical experience, the authors were surprised by the differences observed in comparison with laparoscopic pneumpoeritoneum (PNOP); retropneumpoeritoneum (RPNOP) seemed to have less ventilatory repercussions. Methods: The authors therefore undertook a study on animal models, Six suckling pigs, newly weaned, each weighing 10 kg successively underwent, at 8-day intervals and in random sequence;aright RPNOP with kidney and vena cava dissection, with insufflation of CO2 at 10 mm Hg of pressure and a PNOP with the same pressure of 10 mm Hg. Results: PETCO2 increased during PNOP, and it remained stable during during RPNOP (P = .035). The ventilatory peak airway pressures (PawP) increased during PNOP, but were not modified during RPNOP (P = .0001). Temperature decreased with time (P = .0001) without difference between the two procedures (P = .34), Conclusions: RPNOP was not associated with any adverse effects on the ventilation despite the insufflation pressure of 10 mm Hg, which allowed a satisfactory working area to be created. Operations by RPNOP could be developed in children with fewer respiratory repercussions than those observed during laparoscopy at an equivalent level of pressure. J Pediatr Surg 34:1514-1517. Copyright (C) 1999 by W.B, Saunders Company.