Superior Mesenteric Artery and Vein Injuries: Operative Strategies and Outcomes

Melmer, Patrick D; Clatterbuck, Brant; Parker, Virginia; Castater, Christine; Klingensmith, Nathan J.; Ramos, Christopher; Busby, Stephanie; Hurst, Stuart; Koganti, Deepika; Williams, Keneesha N.; Grant, April A.; Smith, Randi N.; Benarroch‐Gampel, Jaime; Dente, Christopher J.; Rajani, Ravi R.; Todd, S. Rob; Sciarretta, Jason D.

doi:10.1177/15385744211042491

Cited by 1 publication

(1 citation statement)

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“…Severe abdominal pain, metabolic acidosis with elevated anion-gap, and elevated serum lactate may be found due to bowel ischemia [ 25 ]. Therefore, it is imperative to perform a delayed inspection for bowel viability and an abdominal CT angiogram in cases where the SMA is injured [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

Superior Mesenteric Artery Injury during Robotic Radical Nephrectomy: Scenarios and Management Strategies

Sayegh

Medina

Riva

et al. 2023

JCM

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Injury to the superior mesenteric artery (SMA) is a rare, underreported, and potentially devastating complication. This study aims to propose a systematic workup to describe how to prevent and manage SMA injury in a standardized stepwise manner. Three different instances of intraoperative injury to the SMA are described in an accompanying video. All three occurred when the SMA was misidentified as the left renal artery during left robotic radical nephrectomy. In the first case, the SMA was mistakenly identified as the renal artery, but after further dissection, the real renal artery was identified and SMA injury was prevented. In the second case, the SMA was clipped and the real left renal artery was subsequently identified, requiring clip removal. In the third case, the SMA was clipped and completely transected, requiring prompt repair by vascular surgery with a successful outcome. This study aims to propose a systematic workup to describe how to prevent and manage SMA injury in a standardized stepwise manner. The proper anatomic recognition of the SMA may prevent its injury. Intraoperative SMA injury should be promptly identified and repaired to avoid its devastating consequences.

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Section: Discussionmentioning

confidence: 99%