Repair of complex renal artery aneurysms by laparoscopic nephrectomy with ex vivo repair and autotransplantation

(A and B) Representative angiography images of preoperative renal artery aneurysms successfully treated with this technique.

A, Schematic drawing illustrating resection of the renal artery aneurysm. Inset in left upper corner demonstrates standard laparoscopic port placement and Gibson extraction incision for laparoscopic nephrectomy. B, Aneurysm resection following laparoscopic nephrectomy.

Illustration detailing reversed saphenous vein graft extensions to arterial branches.

A, Illustration depicting reimplantation of the kidney following successful arterial, venous and ureteral anastomoses. B, Successful ileo-renal bypass following nephrectomy and aneurysmectomy.

Representative magnetic resonance angiography performed to evaluate for pseudoaneurysm in a postoperative patient 10 years following laparoscopic nephrectomy and ex vivo aneurysm repair and autotransplantation. Three patent anastomoses between the saphenous vein graft extensions and the external iliac artery are illustrated.