後腹腔鏡手術對於年輕的泌尿科醫師而言，是很困難的。因此，我們使用六隻小豬作為實驗對象，嘗試建立一個後腹腔鏡腎臟摘除術的動物模型，並以此動物模型作為年輕的泌尿科醫師訓練後腹腔鏡手術的一個方式。我們使用14號的Veress氏針，以外部定位的方式，插入後腹腔中加以充氣。當後腹腔充氣完成之後，再使用改良式的氣球分離術，來擴大後腹腔的容積。總共有四隻套管被置入其中來進行手術。我們也發現曾經有一次veress 氏針被誤插人一隻小豬的腰部肌肉中。在操作器械的過程裡，每一隻豬都發生腹膜破裂的現象。而我們認為那是小豬的後腹腔過小的結果。大部份的破裂是發生在套管沿前腋線置入的時候。一旦發生腹膜破裂的現象，整個後腹腔就會馬上塌陷。在這種沒有膨脹的後腹腔中操作器械，將會變的非常困難。然而，內視鏡腎臟摘除術依然可以藉由合併經腹腔及經後腹腔的方式來完成。腎臟血管可以很安全的經由內視鏡止血夾來控制。所摘除的腎臟以及上三分之一的輸尿管，是經由一個五公分的切口直接取出，或將腎臟置入標本袋並以環形鉗夾碎後取出。手術平均時間為一小時四十一分鐘。並無發生重大併發症及因手術而死亡的例子。其中有五隻實驗動物發生明顯的皮下氣腫，但是，這並不影響整個手術之進行。我們認為此動物模型，以上述之方法進行後腹腔鏡腎臟摘除術，對於年輕的泌尿科醫師而言，在技術上是可行的。然而，為降低腹膜破裂之發生率，並且讓整個手術都在後腹腔中完成，以較大型動物進行實驗是可能需要的。

Retroperitoneoscopic surgery is difficult for young urologists. Hence, in an attempt to establish an animal model of retroperitoneoscopic nephrectomy as a training of retroperitoneoscopic surgery for young urologists, six pigs were used as subjects. A 14G Veress needle was inserted blindly into the retroperitoneal space to create pneumoretroperitoneum. A modified balloon dissection was used to develop the retroperitoneal space after the pneumoretroperitoneum was established. A total of four trocars were placed within the confines of developed space. A Veress needle, misplaced into the flank muscle, was found in one animal. During manipulation of instruments, peritoneal tears were noted in every pig, a result of the limited retroperitoneal cavity in the small pigs. Most of the tears occurred when the trocar was placed along the anterior axillary line. Once the peritoneal tear occurred, the retroperitoneal space shrank immediately, making instrumental manipulation extremely difficult in the non- distended retroperitoneum. However, endoscopic nephrectoniy could still be completed by a combined transperitoneal and retroperitoneal approach. The renal pedicles could be controlled safely with endoclips. The removed kidney and upper third ureter were taken out of the body either by a 5-cm incision or by retrieval within a Lapsac® (Cook Urological, U.S.A.) after the kidney was mechanically morcellated with a ring forceps. The average operative time was 1 hour and 41 minutes (range: 55 minutes to 2 hours and 35 minutes). No major complication or operative mortality was encountered. Marked subcutaneous emphysema developed in five animals but did not hinder completion of the procedures. This animal model for retroperitoneoscopic nephrectomy is technically feasible for young urologists using method described above. However, a bigger animal may be needed to achieve a lower incidence of peritoneal tear, and to allow the procedure to be accomplished exclusively within the retroperitoneunt.