Laparoscopic Left Renal Vein Transposition for Nutcracker Syndrome

Guňka, I; Navrátil, Pavel; Leško, Michal; Jiška, Stanislav; Raupach, Jan

doi:10.1016/j.avsg.2015.09.010

Cited by 11 publications

(9 citation statements)

References 16 publications

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“…[20] This procedure can be conducted either with open surgery or laparoscopy. [21] Ahmed et al [22] concluded that LRV transplantation is the optimal management option for NCS. However, it is carried out through a midline transperitoneal approach, which entails the risks of LRV thrombosis (about 12.5%) and intractable hematuria (about 12.5%–14.3%), eventually leading to nephrectomy.…”

Section: Discussionmentioning

confidence: 99%

A minimally invasive alternative for the treatment of nutcracker syndrome using individualized three-dimensional printed extravascular titanium stents

Wang

Guo

Jiao

et al. 2019

Chinese Medical Journal

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Background This study was designed to evaluate the clinical and radiographic outcomes of patients with nutcracker syndrome (NCS) who were treated with three-dimensional printing (3DP) extravascular titanium stents (EVTSs). The 3DP EVTS was expected to release the hypertension of the left renal vein (LRV) produced by its compression between the superior mesenteric artery (SMA) and the aorta without causing any complications. Method The pre-operative kidney model of each patient was printed out to enable surgical planning. After that, the EVTS was designed based on the LRV's primitive physiologic structure using computer-aided design software, and each stent was printed out with a precision setting of 20 μm. Seventeen patients who had been suffering from NCS underwent laparoscopic 3DP EVTS placement. The surgical procedure was designed for the placement of EVTS, taking great care in positioning and fixing the stent. Surgical data, which included patient demographic characteristics as well as pre- and post-operative test results, were collected and analyzed. Results The mean duration of surgery was 75 ± 9 min, and the mean blood loss was 20 ± 5 mL. Computed tomography examinations revealed that the pre- and post-operative angle between the SMA and the aorta ranged from 18.7° ± 4.3° to 48.0° ± 8.8° ( P < 0.05); in patients with left varicocele, the mean diameter of the left spermatic vein ranged from 3.7 ± 0.5 to 1.3 ± 0.2 mm ( P < 0.05). Moreover, Doppler ultrasound examinations showed that the peak velocity of blood flow at the hilar area ranged from 12.4 ± 3.3 to 18.5 ± 3.4 cm/s ( P < 0.05). No side effects were observed in the 24 to 42 months following surgery. Conclusion The findings after 2 years of follow-up suggest that the 3DP EVTS is a safe and effective minimally invasive alternative for the treatment of NCS.

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Section: Discussionmentioning

confidence: 99%

A minimally invasive alternative for the treatment of nutcracker syndrome using individualized three-dimensional printed extravascular titanium stents

Wang

Guo

Jiao

et al. 2019

Chinese Medical Journal

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“…6,10,11 These techniques can also be performed via laparoscopic access, but experience is limited. 12 Transposition of the renal vein has been the gold standard for treatment and proven effective. It was employed for the first time in 1982, and appears to be the most common surgical intervention.…”

Section: Discussionmentioning

confidence: 99%

“…The procedure is performed using a mid-line transperitoneal approach (mini laparotomy). 11,12 Nevertheless, since 1996, endovascular approaches have been gaining in popularity, and have even been recommended as first-line treatment. 13 Endovascular stent placement is usually preferable to open surgery, because of the long duration of renal congestion, the greater possibility of complications in these cases, and the need for extensive dissection in this type of operation.…”

Section: Discussionmentioning

confidence: 99%

Tratamento endovascular da síndrome de quebra-nozes: relato de caso

Agle

Filho²,

Almeida

et al. 2019

J. vasc. bras.

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Resumo A dor pélvica crônica é uma doença debilitante, com impacto na qualidade de vida e custos para os serviços de saúde. A síndrome de quebra-nozes é uma importante causa dessa dor, e se refere a um conjunto de sinais secundários à compressão da veia renal esquerda, mais comumente entre a artéria mesentérica superior e a aorta. Seu tratamento ainda permanece controverso e varia de acordo com a gravidade clínica do paciente. Contudo, a técnica endovascular com implante de stent em veia renal tem obtido excelentes resultados. Relatamos um caso de uma paciente de 59 anos submetida a correção endovascular com stent autoexpansível de nitinol. São apresentados dados clínicos, detalhes do procedimento e resultados do acompanhamento dessa paciente. O sucesso técnico foi obtido e não houve relato de complicações pós-operatórias. Pôde-se observar alívio dos sintomas e melhora nos exames de imagem realizados no acompanhamento de curto prazo.

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“…Another less invasive alternative to open surgery is laparoscopic LRV transposition. 9 , 10 Robotic surgery has been developed to overcome many of the surgical disadvantages associated with laparoscopic surgery by increasing the range of motion for instruments, the vision of operative field, and the surgeon's comfort and by eliminating human tremors. 11 We believe robotic renal vein transposition is superior to laparoscopic surgery for these reasons.…”

Section: Discussionmentioning

confidence: 99%

Robotic-assisted left renal vein transposition as a novel surgical technique for the treatment of renal nutcracker syndrome

Chau

Abdul-Muhsin

Peng

et al. 2018

Journal of Vascular Surgery Cases, Innovations and Techniques

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Renal nutcracker syndrome is an anatomic anomaly characterized by the compression of the left renal vein between the superior mesenteric artery and the aorta or between the aorta and the vertebral body. Diagnosis is often challenging. Common presenting symptoms include hematuria, abdominal pain, and pelvic congestion. Several open and endovascular techniques have been described to treat this syndrome. We report a novel surgical technique with robotic-assisted left renal vein transposition to treat a 19-year-old woman with renal nutcracker syndrome. Robotic vascular surgery can be a safe and effective therapy for this condition.

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Laparoscopic Left Renal Vein Transposition for Nutcracker Syndrome

Cited by 11 publications

References 16 publications

A minimally invasive alternative for the treatment of nutcracker syndrome using individualized three-dimensional printed extravascular titanium stents

A minimally invasive alternative for the treatment of nutcracker syndrome using individualized three-dimensional printed extravascular titanium stents

Tratamento endovascular da síndrome de quebra-nozes: relato de caso

Robotic-assisted left renal vein transposition as a novel surgical technique for the treatment of renal nutcracker syndrome

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