Laparoscopic Left Renal Vein Transposition for Nutcracker Syndrome

Ann Vasc Surg. 2016 Feb:31:209.e1-5. doi: 10.1016/j.avsg.2015.09.010. Epub 2015 Nov 26.

Abstract

The left renal vein (LRV) reimplantation into the distal inferior vena cava is considered to be the gold standard of care for symptomatic nutcracker syndrome (NCS). The vast majority of these surgical procedures are performed by open surgery. Experiences with minimally invasive laparoscopic surgery in this field are very limited. We present a case of a 17-year-old boy with NCS in whom the transposition of the LRV was done laparoscopically. The patient suffered from left flank pain, painful left-sided varicocele, microscopic hematuria, proteinuria, and oligoasthenospermia. There were no intraoperative complications, and the postoperative course was uneventful. At 12-month follow-up, hematuria, left flank pain, and left testicular pain resolved. Duplex ultrasonography revealed patent LRV. Laparoscopic LRV transposition appears to be safe, feasible, and has favorable postoperative course.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Humans
  • Laparoscopy*
  • Male
  • Phlebography / methods
  • Renal Nutcracker Syndrome / diagnosis
  • Renal Nutcracker Syndrome / physiopathology
  • Renal Nutcracker Syndrome / surgery*
  • Renal Veins / diagnostic imaging
  • Renal Veins / physiopathology
  • Renal Veins / surgery*
  • Replantation
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Ultrasonography, Doppler, Duplex
  • Vascular Patency
  • Vena Cava, Inferior / surgery