Vascular Injuries During A Robotic Left Radical Nephrectomy: Case Report

We describe a case of 57year-old Caucasian female who presented with a 9cm mostly endophytic solid left renal mass to the urologic-oncology service at our institution. The patient elected for a robot-assisted laparoscopic left radical nephrectomy. During the procedure, we encountered inadvertent injuries to both the contralateral right renal artery and the superior mesenteric artery (SMA). We promptly identified the injuries and we immediately summoned the vascular surgery team and converted to open surgery. Vascular surgery team performed an end to end repair to the injured right renal artery and placed a polytetrafluoroethylene (PTFE) graft to repair the injured SMA. The kidney showed signs of recovery in the immediate postoperative period and the bowel looked viable as well. However, eventually the small bowel suffered massive gangrene and sadly, the patient died on postoperative day 4.

Keywords: Robotic; Nephrectomy; Superior mesenteric artery; Renal artery; Contralateral; Injury

Abbreviations: OR: Operating Room; PTFE: Polytetrafluorethylene; RP: Radical Prostatectomy; SMA: Superior Mesenteric Artery.