# Modified technique for dissection of working space in retroperitoneal laparoscopic surgery: A step‐by‐step guide

## TL;DR

This paper introduces a modified laparoscopic technique for safely creating a working space in the retroperitoneum during surgery.

## Contribution

A novel step-by-step modified dissection technique for retroperitoneal laparoscopic surgery is described and validated.

## Key findings

- The modified technique successfully created a satisfactory retroperitoneal working space in all 47 patients.
- No dissection-related complications were observed during follow-up.
- The method is described as safe, simple, and minimally invasive with an excellent surgical view.

## Abstract

This work aims to describe with a step‐by‐step guide for modified dissection technique to create a retroperitoneal working space during laparoscopic surgery.

From May 2021 to December 2022, we performed a modified dissection technique to create a retroperitoneal working space prior retroperitoneal laparoscopic surgery in 47 patients. The retroperitoneum is initially accessed by puncturing the trocar through a 10‐mm transverse skin incision in the midaxillary line. Under endoscopic monitoring, the tip of the trocar is adjusted to a relative avascular layer between the transversus abdominis muscle and the pararenal fat. Laparoscopic dissection is performed to develop until the working space is fully established.

In all cases, a satisfactory retroperitoneal space was created for surgery. No dissection‐related complications were noted within a median follow‐up period of 9 (IQR:7,15) months.

Modified retroperitoneal dissection with laparoscopy is a safe, simple, effective, and minimally invasive technique. It provides an adequate working space and an excellent view without obvious bleeding.