Balloon dissection in extended retroperitoneoscopy.

The anatomy of the retroperitoneum, including the high retroperitoneum, was studied as it appears with balloon dissecting techniques. We used fresh cadavers in this study. A relatively unknown fascia that is located between the lateral aspect of the perirenal fascia and the posterior parietal peritoneum, called the paraconal fascia, was a constant finding. This structure is important because it protects delicate retroperitoneal organs: the duodenum, pancreas, celiac axis, and superior mesenteric artery. Locating this fascia is an important step in the dissection of the high retroperitoneum, which is of interest in advanced videoendoscopic procedures involving retroperitoneal organs.