Access for retroperitoneoscopy in small infants

This video describes in detail our current technique for laparoscopic port placement in infants when using retroperitoneoscopy. More than 60 ablative and reconstructive renal surgeries have been performed since 2017 using this retroperitoneoscopic approach in infants weighing less than 10 Kg, with no conversions or complications linked to access or port placement. It is our impression that retroperitoneoscopy is very similar in smaller children, and might have some advantages such as shorter distance between entry point and target organ and more flexible abdominal wall. This video shows a combination of 5 mm and 3 mm ports, allowing use of all current types of energy devices, clip appliers and single use scissors, and also excellent vision during initial dissection. This approach has been used in our university centers for nephrectomies, hemi-nephrectomies, pyeloplaties and uretero-ureterostomies.