Objective: Optimal retroperitoneal space creation is of pivotal importance in laparoscopic retroperitoneal surgery. The aim of this study is to report the balloon dissecting technique developed at our institution, comparing the costs of such device with that of the commercially available balloon retroperitoneal expanders. Materials and Methods: Twenty patients, scheduled to undergo retroperitoneoscopic surgery, were randomly divided into two groups. In group 1, retroperitoneal dilatation was performed with the commercially available balloon expander. In group 2, we employed the original balloon dilator created with two middle fingers of a #8 powder-free surgical glove tied to a nondisposable 11 mm trocar and filled with 600 mL of saline, employing simultaneously two 50 mL syringes. Subjective evaluation of the created space was performed by a surgeon blinded in both groups. Economical evaluation included the costs of the disposable materials and of the time in the operative room required to create the dilation. Results: In all the cases, the created dilatation was considered good. In group 1, the time required to dilate the retroperitoneal space was medially 3.15 minutes, whereas in group 2, the time required to prepare the dissecting balloon was medially 1.16 minutes and the time required to dissect the retroperitoneal space was 4.41 minutes (total 5.57 minutes). Considering the costs of the disposable material, the overall costs to create the retroperitoneal space resulted to be 141.95€ in group 1 and 60.27€ in group 2 (p < 0.005). Conclusion: The original dissecting balloon employed at our institution revealed to be easy and of fast manner and offers a valid option for the proper retroperitoneal dissection. Moreover, it revealed to be cost-effective compared with the commercially available supply.
Keywords: dissecting balloon; economics; retroperitoneoscopy.