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Laparoscopic Left Renal Vein Transposition for Nutcracker Syndrome.
Igor Gunka1, Pavel Navratil2, Michal Lesko1
1Department of Surgery, University Hospital and Faculty of Medicine Hradec Kralove, Charles University in Prague, Hradec Kralove, Czech Republic.
Annals of Vascular Surgery
|December 3, 2015
Summary
Laparoscopic left renal vein transposition is a safe and effective treatment for symptomatic nutcracker syndrome (NCS). This minimally invasive approach offers a favorable outcome for patients experiencing flank pain and related symptoms.
Area of Science:
- Urology
- Minimally Invasive Surgery
- Vascular Surgery
Background:
- Nutcracker syndrome (NCS) is a condition caused by the compression of the left renal vein.
- Symptomatic NCS often requires surgical intervention, with left renal vein (LRV) reimplantation into the inferior vena cava being the gold standard.
- Open surgical procedures are the predominant method for treating NCS.
Observation:
- A 17-year-old male presented with symptomatic NCS, including left flank pain, left varicocele, hematuria, proteinuria, and oligoasthenospermia.
- The patient underwent a laparoscopic transposition of the LRV.
- The procedure had no intraoperative complications and an uneventful postoperative course.
Findings:
- At 12-month follow-up, the patient's symptoms of hematuria, left flank pain, and left testicular pain resolved.
- Duplex ultrasonography confirmed the patency of the left renal vein.
- Laparoscopic LRV transposition demonstrated safety and feasibility.
Implications:
- Laparoscopic LRV transposition is a viable alternative to open surgery for NCS.
- Minimally invasive techniques can provide favorable outcomes in managing nutcracker syndrome.
- This approach may reduce patient morbidity and improve recovery times.
