Authors of section

Author

Jean Ouellet

General Editor

Luiz Vialle

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Retroperitoneal approach

1. Skin incision

Under fluoroscopic control, the L5-S1 disk level is identified.

retroperitoneal approach

The skin is incised on the mark.

retroperitoneal approach

2. Exposure

After dissection of the subcutaneous tissue, the anterior rectus sheet is incised and the rectus muscle is mobilized to the medial or lateral side, depending on the incision and surgeon's preference.

retroperitoneal approach

The posterior rectus sheet is opened and the peritoneum is exposed.

retroperitoneal approach

Next the peritoneum is carefully retracted using a hand.

retroperitoneal approach

For L5/S1, the vertebrae are accessed in between the vessels bifurcation.

retroperitoneal approach

3. Retraction system

A retraction system is mandatory at this point.

anterior fusion of l5 s1

4. Closure

A retroperitoneal drain is inserted.

retroperitoneal approach

The wound is then closed in layers.

retroperitoneal approach