Robot-assisted laparoscopic reconstructed management of multiple aneurysms in renal artery primary bifurcations: a case report and literature review

Abstract

BackgroundRenal artery aneurysm (RAA) is rare and its incidence in the general population remains elusive. There have been few reports on the repair of multiple aneurysms conducted with the Da Vinci robot-assisted surgical platform (Intuitive Surgical Inc., Sunnyvale, CA, USA), especially for those located in renal artery primary bifurcations.Case presentationWe report our experience in the surgical management of two expanding right-sided RAAs in a 64-year-old man using a robot-assisted laparoscopic approach. Two aneurysms were located in renal artery primary bifurcations, whose diameter was 1.8 and 1.2 cm. The aneurysms were resected and the renal artery branch reconstructed by in situ arteriorrhaphy. The operation lasted for 2 h and 35 min with a warm ischemia time of 26 min and estimated blood loss of 150 ml. The hospital stay was 6 days. The computed tomography (CT) scan performed 2 months after the surgery showed resolution of the aneurysms. Additionally, split renal function indicated the preservation of right renal function in the follow-up period.ConclusionsThe robot-assisted laparoscopic procedure is a safe and effective surgical technique, which may be considered as an alternative to open surgery for complex multiple RAAs in the future.

Blood pressure and renal outcomes after renal artery aneurysm intervention: Single-center experience and review of literature

“…Regarding the number of antihypertensive medicines, follow-up results from 3 studies all reported a decrease. Sixteen papers concerning renal function were included (Table 5) (7,8,10,(18)(19)(20)(21)(23)(24)(25)(26)(27)(28)(29). In total, 277 and 162 patients received open or endovascular repair, respectively.…”

Robot-assisted laparoendoscopic single-site surgery for the simultaneous management of multiple urinary tract calculi: a case report and experience sharing

“…From the earliest AESOP and ZEUS to the latest da Vinci Xi, robot-assisted surgeries have been increasingly used in clinical practice. In the field of urology, da Vinci system offer advantages to tumor resection and urinary reconstruction [11, 12]. However, in the treatment of urinary calculi, da Vinci system is often used in performing nephrolithotomy [13, 14] or ureteroscopy lithotripsy during the robot-assisted pyeloplasty for ureteropelvic junction obstruction [15, 16].…”

Spontaneous Renal Artery Aneurysm Rupture And Its Endovascular Treatment

“…In the case presentation by Wei Hb et al, two aneurysms in renal artery primary bifurcations with diameters of 1.8 and 1.2 cm in a patient were successfully resected using Robot guided laparoscopic approach. (7) In the retrospective study by Guo H et al, 27 patients treated with transarterial embolisation due to iatrogenic renal pseudoaneurysm and arteriovenous fistula were covered and technical and clinical success ratios were detected as 100% and 96.3% in order (8).…”