Laparoscopic nephrectomy with ex vivo repair of aneurysm and autotransplantation

The perceived prevalence of renal artery aneurysms is increasing, probably because of the widespread use of cross-sectional imaging. The majority of these aneurysms are found incidentally and are asymptomatic. There are no clear guidelines for when to repair these aneurysms, although most practitioners recommend intervention around the 2- to 3-cm size cutoff. These can be managed endovascularly or with open surgery; however, aneurysms at the hilum may require a complex repair to avoid nephrectomy. We present a case of a hilar renal artery aneurysm managed with laparoscopic nephrectomy with ex vivo aneurysm resection and repair followed by autotransplantation.