V03-01: Robot-assisted renovascular reconstruction for renal artery aneurysm
Renal artery aneurysms represent a rare clinical entity, and most are managed with endovascular techniques when treatment is indicated. Laparoscopic and robot assisted repair of renal artery aneurysms has been described; however, few reports exist in the literature. The aim of this video is to describe a robot assisted laparoscopic technique for resection and repair of a renal artery aneurism when endovascular treatment is not amenable.
We present the clinical case of a 32 year-old woman, smoker, with desire for pregnancy and a right renal aneurysm of 21x17 mm that was found in a CT scan performed due to a thoracic trauma in February 2017. The CT angiogram showed 4 vessels of the same calibre arising from the aneurysm and going to the parenquima. The placement of a multilayer stent was ruled out due to the complexity of the aneurysm and the patient was proposed a robot assisted laparoscopic repair. The technique used is explained in the video.
Serum creatinine levels 24 hours after surgery were 53 umol/L. The angiogram 24 hours after surgery showed an homogeneous arrival of the tracer in all the parenquima without ischemic zones. The patient was discharged 72 hours after the surgery without complications. The ultrasound 1 week after surgery had no significant findings and the vascular parameters of the kidney were normal. CT angiogram 1 month later showed the whole kidney well perfused and the aneurysm repaired respecting the 4 branches.
Robot-assisted laparoscopic renal artery aneurysm repair is an option when endovascular treatment is not amenable. The use of the robotic surgical platform facilitated aneurysm resection and suturing during this procedure, avoiding extracorporeal repairing surgery and autotransplantation.