V2161: Robotic Renal Artery Aneurysm Repair with Intra-arterial Renal Hypothermic Perfusion

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Introduction and Objectives
Complex renal artery aneurysm involving multiple branch vessels is a challenging scenario. The use of renal cold perfusion is recommended when warm ischemia times are expected to exceed 30 minutes. We present a case of robot-assisted laparoscopic repair of a complex renal artery aneurysm with the use of intra-arterial hypothermic kidney perfusion.

Methods
A 49 year old female with left flank pain and hypertension was found to have a complex renal artery aneurysm. She underwent a robotic renal artery aneurysm repair with intra-arterial renal hypothermic perfusion.

Results
Warm ischemia time was 29 minutes for the first aneurysm repair. The kidney was then re-perfused for 60 minutes followed by re-clamping and repair of the second aneurysm with a warm ischemia time of 26 minutes. Total operative time was 210 minutes .The patient was discharged on postoperative day 2. A follow-up at 4 months demonstrated stable renal function with resolution of her flank pain and normalization of the blood pressure.

Conclusions
Robotic repair of complex renal arterial aneurysm with intra-arterial cooling is feasible and a safe option when prolonged renal ischemia is expected.

Funding: none