title: Left transperitoneal laparoscopic partial nephrectomy in the presence of a left-sided inferior vena cava.
abstract: OBJECTIVE
  To report a case and the surgical techniques of transperitoneal laparoscopic partial nephrectomy (LPN) in a patient with a small left renal mass and an aberrant left-sided inferior vena cava (IVC).
  
  
  METHODS
  An otherwise healthy 49-year-old man with a body mass index of 23.1 kg/m(2) was diagnosed with a 5 × 6-cm mass in the left kidney. A transperitoneal LPN was performed in the presence of a left-sided IVC. The procedure was completed using standard laparoscopic instruments. The left renal vein was identified, with the gonadal vein used as an anatomic landmark. Slightly rostral to the location where the renal vein emptied into the left-sided IVC, 2 renal arteries were dissected and clamped individually using laparoscopic bulldog clamps. A standard LPN was then completed.
  
  
  RESULTS
  The duration of the surgery was 182 minutes, and there was an estimated blood loss of 100 mL. The warm ischemic time was 31 minutes. The postoperative recovery was uneventful, and the patient was discharged to his home on postoperative day 7. A pathologic examination revealed a renal oxyphilic adenoma, which is a benign lesion. At the follow-up visits that were 1 month and 3 months after surgery, the patient was determined to be clinically healthy.
  
  
  CONCLUSIONS
  The anomaly of a left-sided IVC is not an impediment to performing a transperitoneal LPN; however, the correct identification of the anatomical landmarks and the use of meticulous intraoperative techniques are of paramount importance during this procedure.
authors.affiliation: Department of Urology, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Lin Hui
authors.initials: LH
authors.lastname: Wang
authors.forename: Bing
authors.initials: B
authors.lastname: Liu
authors.forename: Zhenjie
authors.initials: Z
authors.lastname: Wu
authors.forename: Qing
authors.initials: Q
authors.lastname: Yang
authors.forename: Liang
authors.initials: L
authors.lastname: Xiao
authors.forename: Wei
authors.initials: W
authors.lastname: Chen
authors.forename: Haibo
authors.initials: H
authors.lastname: Sheng
authors.forename: Wenbin
authors.initials: W
authors.lastname: Luo
authors.forename: Rui
authors.initials: R
authors.lastname: Luo
authors.forename: Yinghao
authors.initials: Y
authors.lastname: Sun
mesh_terms: D006801:Humans; D007680:Kidney Neoplasms / Q000150:complications* / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D010537:Peritoneum; D014682:Vena Cava, Inferior / Q000002:abnormalities*