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Robot‐assisted laparoscopic renal artery aneurysm repair with selective arterial clamping
Author(s) -
Samarasekera Dinesh,
Autorino Riccardo,
Khalifeh Ali,
Kaouk Jihad H
Publication year - 2014
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/iju.12189
Subject(s) - medicine , renal artery , dissection (medical) , aneurysm , renal ischemia , ischemia , kidney , surgery , renal function , radiology , cardiology , reperfusion injury
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. We describe our experience with the surgical management of a 1.6‐cm right‐sided renal artery aneurysms in a 35‐year‐old man who presented with flank pain. Using the DaVinci S i surgical platform ( I ntuitive, S unnyvale, CA , USA), the aneurysm was resected and the renal artery was reconstructed. Segmental branches of the renal artery were dissected and selectively clamped during resection, allowing for regional rather than global renal ischemia. Operative time was 240 min, with an estimated blood loss of 200 cc. Warm ischemia time was only regional, for a duration of 44 min. Follow‐up functional analysis showed preserved renal function in the right kidney. We describe our technique and show the technical feasibility of robot‐assisted renal artery aneurysm repair. Furthermore, use of the DaVinci S i system facilitates segmental artery dissection, and allows for selective clamping during reconstruction. This avoids global renal ischemia and optimizes functional preservation.