Laparoscopic transposition of the left renal vein into the inferior vena cava for nutcracker syndrome Olivier Hartung, MD, Amine Azghari, MD, Pierre.

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Laparoscopic transposition of the left renal vein into the inferior vena cava for nutcracker syndrome Olivier Hartung, MD, Amine Azghari, MD, Pierre Barthelemy, MD, PhD, Mourad Boufi, MD, Yves S. Alimi, MD, PhD Journal of Vascular Surgery Volume 52, Issue 3, Pages 738-741 (September 2010) DOI: 10.1016/j.jvs.2010.04.018 Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 1 Preoperative selective phlebography. A, Left renal vein phlebography showing a tight stenosis with left ovarian vein reflux. B, Reflux in the left gonadic vein while injecting into the left renal vein; the left ovarian plexus drains into the left internal iliac vein. Journal of Vascular Surgery 2010 52, 738-741DOI: (10.1016/j.jvs.2010.04.018) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 2 Laparoscopic approach. A, Trocar positioning. 1, suction; 2 and 3, instruments; 4, camera; R, point of insertion of the retractor (Retis, Protomed, Marseille, France); C, point of insertion of the laparoscopic clamp (B/Braun-Aesculap, Tuttlingen, Germany). B, View after placement of the laparoscopic retractor (Retis, Protomed, Marseille, France) and opening of the retroperitoneal space. C, View after dissection of the left renal vein and the inferior vena cava. D, Section of the left adrenal vein. Journal of Vascular Surgery 2010 52, 738-741DOI: (10.1016/j.jvs.2010.04.018) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 3 Operative view. A, Section of the LRV on the IVC. B, Laparoscopic reimplantation of the LRV into the infra-renal IVC using 6/0 PTFE running suture. C, Result after unclamping. D, Perioperative completion angiography. Journal of Vascular Surgery 2010 52, 738-741DOI: (10.1016/j.jvs.2010.04.018) Copyright © 2010 Society for Vascular Surgery Terms and Conditions