Total laparoscopic renal artery bypass for restenosis after failed percutaneous transluminal renal stenting Jérôme Cau, MD, Jean Baptiste Ricco, MD,

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Presentation transcript:

Total laparoscopic renal artery bypass for restenosis after failed percutaneous transluminal renal stenting Jérôme Cau, MD, Jean Baptiste Ricco, MD, Olivier Page, MD, Gilles Régnault de la Mothe, MD, Christophe Marchand, MD, Alexandre Valagier, MD Journal of Vascular Surgery Volume 53, Issue 1, Pages 87-91 (January 2011) DOI: 10.1016/j.jvs.2010.08.021 Copyright © 2011 Society for Vascular Surgery Terms and Conditions

Fig 1 Positioning of the patient with an inflatable bolster placed under the left flank and tilted to the right at 45 degrees with placement of the laparoscopic trocars: 1, proximal aortic clamp; 2, dissecting instruments and needle holder; 3, bowel retractor; 4, assistant operating channel for suction; 5, distal aortic clamp; and 6, camera. Journal of Vascular Surgery 2011 53, 87-91DOI: (10.1016/j.jvs.2010.08.021) Copyright © 2011 Society for Vascular Surgery Terms and Conditions

Fig 2 A, Operative view showing the exposure of the left renal artery from its origin to its bifurcation with dissection of the left renal vein. B, Operative view showing a left aorto-renal bypass implanted on the left side of the infrarenal aorta with a distal end-to-end anastomosis on the renal artery. Journal of Vascular Surgery 2011 53, 87-91DOI: (10.1016/j.jvs.2010.08.021) Copyright © 2011 Society for Vascular Surgery Terms and Conditions

Fig 3 A, Operative view showing the right renal artery anastomosis. This exposure was obtained after incision of the Toldt fascia and mobilization of the right side of the colon and of the duodenum, followed by dissection of the left renal vein at its junction with the inferior cava. B, Operative view showing the completed right aortorenal bypass with transposition of the renal artery in front of the vena cava. C, Control aortogram of the right aortorenal bypass (black arrow), showing also a left renal artery stenosis (white arrow). Journal of Vascular Surgery 2011 53, 87-91DOI: (10.1016/j.jvs.2010.08.021) Copyright © 2011 Society for Vascular Surgery Terms and Conditions

Fig 4 Contrast-enhanced computed tomographic scan of a left aortorenal bypass at 12 months in 1 patient with a solitary kidney. Journal of Vascular Surgery 2011 53, 87-91DOI: (10.1016/j.jvs.2010.08.021) Copyright © 2011 Society for Vascular Surgery Terms and Conditions