Laparoscopic repair of renal artery aneurysm

Purpose: We describe technical considerations of the laparoscopic repair of a renal artery aneurysm. Materials and Methods: A 57-year-old woman presented with a 3 cm. aneurysm of the distal left main renal artery at its bifurcation. Using a purely lap aroscopic 4-port transperitoneal technique the aneurysm was completely mobi lized from its location behind the renal vein. Its 3 feeding vessels were c ontrolled individually with bulldog clamps. The aneurysm sac was bivalved a nd precisely trimmed to conform with the diameter of the main renal artery. Vascular reconstruction was performed with running freehand laparoscopic s uturing and intracorporeal knot tying using 4-zero polypropylene suture. Results: Warm ischemia time was 31 minutes, total operative time was 4.2 ho urs, blood loss was 100 cc and hospital stay was 2 days. Postoperatively re nal scan showed improved perfusion and renal arteriography confirmed adequa te repair of the aneurysm. Conclusions: Laparoscopic repair of the renal artery aneurysm is feasible. To our knowledge we present the initial clinical report of laparoscopic ren ovascular surgery in the literature.