Wei Hai-Bin, Qi Xiao-Long, Liu Feng, Wang Jie, Ni Xiao-Feng, Zhang Qi, Li En-Hui, Chen Xuan-Yu, Zhang Da-Hong
Department of Urology, Zhejiang Provincial People's Hospital, No. 158, Shangtang Road, Xiacheng District, Hangzhou, Zhejiang, 310014, China.
Department of Nephrology, Sir Run Run Shaw Hospital, No. 3, East Qingchun Road, Jianggan District, Hangzhou, Zhejiang, 310076, China.
BMC Urol. 2017 Oct 16;17(1):96. doi: 10.1186/s12894-017-0265-8.
Renal artery aneurysm (RAA) is rare and its incidence in the general population remains elusive. There have been few reports on the repair of multiple aneurysms conducted with the Da Vinci robot-assisted surgical platform (Intuitive Surgical Inc., Sunnyvale, CA, USA), especially for those located in renal artery primary bifurcations.
We report our experience in the surgical management of two expanding right-sided RAAs in a 64-year-old man using a robot-assisted laparoscopic approach. Two aneurysms were located in renal artery primary bifurcations, whose diameter was 1.8 and 1.2 cm. The aneurysms were resected and the renal artery branch reconstructed by in situ arteriorrhaphy. The operation lasted for 2 h and 35 min with a warm ischemia time of 26 min and estimated blood loss of 150 ml. The hospital stay was 6 days. The computed tomography (CT) scan performed 2 months after the surgery showed resolution of the aneurysms. Additionally, split renal function indicated the preservation of right renal function in the follow-up period.
The robot-assisted laparoscopic procedure is a safe and effective surgical technique, which may be considered as an alternative to open surgery for complex multiple RAAs in the future.
肾动脉动脉瘤（RAA）较为罕见，其在普通人群中的发病率尚不清楚。关于使用达芬奇机器人辅助手术平台（美国加利福尼亚州森尼韦尔市直观外科公司）进行多发动脉瘤修复的报道较少，尤其是位于肾动脉一级分支处的动脉瘤。
我们报告了一名64岁男性患者，采用机器人辅助腹腔镜手术治疗两个不断增大的右侧肾动脉动脉瘤的经验。两个动脉瘤位于肾动脉一级分支处，直径分别为1.8厘米和1.2厘米。切除动脉瘤后，通过原位动脉缝合重建肾动脉分支。手术持续2小时35分钟，热缺血时间为26分钟，估计失血量为150毫升。住院时间为6天。术后2个月进行的计算机断层扫描（CT）显示动脉瘤消失。此外，分肾功能显示随访期间右肾功能得以保留。
机器人辅助腹腔镜手术是一种安全有效的手术技术，未来对于复杂多发肾动脉动脉瘤，可考虑将其作为开放手术的替代方法。
