title: Encountering the Accessory Polar Renal Artery during Laparoscopic Para-Aortic Lymphadenectomy.
abstract: A 60-year-old Korean woman underwent laparoscopic bilateral salpingo-oophorectomy and was confirmed to have high-grade serous carcinoma of both ovaries with a huge omental cake, extensive agglutinated intra-abdominal metastatic masses, extensive serosa invasion of the intestines, and mesenterial deposits. She underwent 3 cycles of neoadjuvant chemotherapy followed by laparoscopic interval debulking surgery, including hysterectomy, pelvic and para-aortic lymphadenectomy, appendectomy, partial peritonectomy, and omentectomy. We encountered the right accessory polar renal artery (APRA) during the surgery and carefully preserved the right APRA from the abdominal aorta to the right kidney (Fig. 1). Postoperative computed tomography angiography showed an intact right APRA and normal-appearing kidney (Fig. 2). The patient had adjuvant chemotherapy and is alive without disease recurrence. Because APRA is a functional end artery, it is important to preserve it during surgery to prevent ischemic damage and renal failure [1]. It is very important for the gynecologic-oncologist to have knowledge of the retroperitoneal vascular anatomy, experience in laparoscopic surgery, and an accurate surgical technique to avoid vascular injury during laparoscopic para-aortic lymphadenectomy.
authors.affiliation: Division of Gynecologic Oncology and Gynecologic Minimally Invasive Surgery, Department of Obstetrics and Gynecology, Hanyang University College of Medicine, Seoul, Republic of Korea.
authors.forename: Won Moo
authors.initials: WM
authors.lastname: Lee
authors.affiliation: Division of Gynecologic Oncology and Gynecologic Minimally Invasive Surgery, Department of Obstetrics and Gynecology, Hanyang University College of Medicine, Seoul, Republic of Korea. Electronic address: choiyjjy1@hanyang.ac.kr.
authors.forename: Joong Sub
authors.initials: JS
authors.lastname: Choi
authors.affiliation: Division of Gynecologic Oncology and Gynecologic Minimally Invasive Surgery, Department of Obstetrics and Gynecology, Hanyang University College of Medicine, Seoul, Republic of Korea.
authors.forename: Jaeman
authors.initials: J
authors.lastname: Bae
authors.affiliation: Division of Gynecologic Oncology and Gynecologic Minimally Invasive Surgery, Department of Obstetrics and Gynecology, Hanyang University College of Medicine, Seoul, Republic of Korea.
authors.forename: Un Suk
authors.initials: US
authors.lastname: Jung
authors.affiliation: Division of Gynecologic Oncology and Gynecologic Minimally Invasive Surgery, Department of Obstetrics and Gynecology, Hanyang University College of Medicine, Seoul, Republic of Korea.
authors.forename: Jeong Min
authors.initials: JM
authors.lastname: Eom
keywords: Anomaly; Artery; Lymphadenectomy; Ovary cancer