To compare the safety and effectiveness of modified direct trocar insertion and Hasson open technique in retroperitoneal laparoscopic surgery to establish a retroperitoneal space.

The data of 205 cases of retroperitoneal laparoscopy performed by the same surgeon from January 2019 to December 2021 were retrospectively analyzed, and the patients were divided into two groups, of which modified direct trocar insertion was performed in 107 patients to establish a retroperitoneal space (group A), and Hasson open technique was performed in 98 patients (group B). The general situation, average insertion time, trocar leakage, insertion related complications, application of analgesic, VAS score, incision infection, and postoperative hospitalization days of two groups were compared.

The retroperitoneal laparoscopic entry time in group A (6.6±1.8 min) was shorter than that in group B (9.7±1.5 min), P<0.001. Trocar leakage was less in Group A compared to Group B (P=0.030). Insertion related complications in group A were fewer than in group B (P=0.039). Both groups had no major bleeding caused by insertion, no serious complications such as kidney, large blood vessels, intestinal injury, or gas embolism.

The modified direct trocar insertion is a fast, safe and effective method for establishing a retroperitoneal space, it is worth promoting in retroperitoneal laparoscopic surgery.