title: Accessory polar renal artery encountered in transperitoneal systemic laparoscopic paraaortic lymphadenectomy.
abstract: OBJECTIVE
  To increase vigilance among gynecological surgeons for the presence of accessory polar renal artery (APRA) encountered with transperitoneal systemic laparoscopic paraaortic lymphadenectomy (LPAL).
  
  
  METHODS
  A retrospective review was conducted on 156 women who underwent LPAL for various gynecologic malignancies between November 2003 and December 2009.
  
  
  RESULTS
  The median age, parity, body mass index, and number of previous abdominal surgeries, respectively, of the women were 52 years (range, 23-82 years), two (range, 0-7), 24.1 kg/m2 (range, 17.4-35.0 kg/m2), and 0 (range, 0-3). During the study period, we found four women with APRA. There were three cases of right lower APRAs arising from the abdominal aorta, caudal to the inferior mesenteric artery (IMA), terminating at the parenchyma of the lower pole of the right kidney. In the other case, the APRA arose from the abdominal aorta superior to the IMA. There were no vascular complications, such as transection or ligation of the APRA.
  
  
  CONCLUSIONS
  It is important for the gynecological oncologic surgeon to have knowledge of retroperitoneal vascular anatomy, experience in laparoscopic surgery, and an accurate surgical technique to avoid vascular injury during LPAL.
authors: Department of Obstetrics and Gynecology, Flushing Hospital Medical Center, Flushing, NY, USA.
authors: Y S
authors: YS
authors: Lee
authors: J H
authors: JH
authors: Lee
authors: J S
authors: JS
authors: Choi
authors: C E
authors: CE
authors: Son
authors: S W
authors: SW
authors: Jeon
authors: J T
authors: JT
authors: Kim
authors: K J
authors: KJ
authors: Joo
authors: Y S
authors: YS
authors: Cho
authors: U S
authors: US
authors: Jung
mesh_terms: D000328:Adult; D005260:Female; D005833:Genital Neoplasms, Female / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008197:Lymph Node Excision / Q000379:methods*; D008875:Middle Aged; D010537:Peritoneum / Q000601:surgery*; D012077:Renal Artery / Q000002:abnormalities*; D012189:Retrospective Studies