Laparoscopic repair of renal artery aneurysm.
OBJECTIVE
We describe technical considerations of the laparoscopic repair of a renal artery aneurysm.


METHODS
A 57-year-old woman presented with a 3 cm. aneurysm of the distal left main renal artery at its bifurcation. Using a purely laparoscopic 4-port transperitoneal technique the aneurysm was completely mobilized from its location behind the renal vein. Its 3 feeding vessels were controlled individually with bulldog clamps. The aneurysm sac was bivalved and precisely trimmed to conform with the diameter of the main renal artery. Vascular reconstruction was performed with running freehand laparoscopic suturing and intracorporeal knot tying using 4-zero polypropylene suture.


RESULTS
Warm ischemia time was 31 minutes, total operative time was 4.2 hours, blood loss was 100 cc and hospital stay was 2 days. Postoperatively renal scan showed improved perfusion and renal arteriography confirmed adequate repair of the aneurysm.


CONCLUSIONS
Laparoscopic repair of the renal artery aneurysm is feasible. To our knowledge we present the initial clinical report of laparoscopic renovascular surgery in the literature.
Gill
I S
IS
Section of Laparoscopic and Minimally Invasive Surgery, Urological Institute, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
Murphy
D P
DP
Hsu
T H
TH
Fergany
A
A
El Fettouh
H
H
Meraney
A M
AM
D000783:Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D000792:Angiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D012077:Renal Artery / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome