The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Anil Kapoor - One of the best experts on this subject based on the ideXlab platform.
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robot assisted laparoscopic Renal Artery Aneurysm reconstruction
Journal of Vascular Surgery, 2006Co-Authors: Patrick Luke, Bodo E Knudsen, Christopher Nguan, Stephen E Pautler, Stuart Swinnimer, Robert Kiaii, Anil KapoorAbstract:We report the surgical management of an expanding 2.5-cm left-sided Renal Artery Aneurysm using a robotic-assisted laparoscopic approach. Using the da Vinci surgical robotic system, we resected the Aneurysm, and the anterior-inferior branch of the Renal Artery was reconstructed with an end-to-end anastomosis. The operative time was 360 minutes, hospitalization length of stay was 3 days, and postoperative analgesic requirements were minimal. Follow-up imaging and functional analysis demonstrated resolution of the Aneurysm and preservation of Renal function. This technique highlights the ability of surgical robotics to expand indications for minimally invasive surgery in complex cases.
Jihad H Kaouk - One of the best experts on this subject based on the ideXlab platform.
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robot assisted laparoscopic Renal Artery Aneurysm repair with selective arterial clamping
International Journal of Urology, 2014Co-Authors: Dinesh Samarasekera, Riccardo Autorino, Ali Khalifeh, Jihad H KaoukAbstract:Renal Artery Aneurysms represent a rare clinical entity, and most are managed with endovascular techniques when treatment is indicated. Laparoscopic and robot-assisted repair of Renal Artery Aneurysms has been described; however, few reports exist in the literature. We describe our experience with the surgical management of a 1.6-cm right-sided Renal Artery Aneurysms in a 35-year-old man who presented with flank pain. Using the DaVinci Si surgical platform (Intuitive, Sunnyvale, CA, USA), the Aneurysm was resected and the Renal Artery was reconstructed. Segmental branches of the Renal Artery were dissected and selectively clamped during resection, allowing for regional rather than global Renal ischemia. Operative time was 240 min, with an estimated blood loss of 200 cc. Warm ischemia time was only regional, for a duration of 44 min. Follow-up functional analysis showed preserved Renal function in the right kidney. We describe our technique and show the technical feasibility of robot-assisted Renal Artery Aneurysm repair. Furthermore, use of the DaVinci Si system facilitates segmental Artery dissection, and allows for selective clamping during reconstruction. This avoids global Renal ischemia and optimizes functional preservation.
Arto Haapanen - One of the best experts on this subject based on the ideXlab platform.
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Transcatheter embolization of a Renal Artery Aneurysm using ethylene vinyl alcohol copolymer.
CardioVascular and Interventional Radiology, 2007Co-Authors: Riitta Rautio, Arto HaapanenAbstract:Our aim was to treat a clinically silent Renal Artery Aneurysm. The patient was a 76-year-old man with elevated prostate-specific antigen and prostata biopsies with a gradus II–III adenocarcinoma who was incidentally found to have an Aneurysm in his right Renal Artery. We performed a successful transcatheter embolization of the Aneurysm using ethylene vinyl alcohol copolymer (Onyx). To avoid migration of the liquid material into the parent Artery, a balloon was inflated in the orifice of the neck of the Aneurysm while the liquid was injected. Five-month follow-up computed tomography (CT) imaging confirmed total occlusion of the Aneurysm.
Patrick Luke - One of the best experts on this subject based on the ideXlab platform.
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robot assisted laparoscopic Renal Artery Aneurysm reconstruction
Journal of Vascular Surgery, 2006Co-Authors: Patrick Luke, Bodo E Knudsen, Christopher Nguan, Stephen E Pautler, Stuart Swinnimer, Robert Kiaii, Anil KapoorAbstract:We report the surgical management of an expanding 2.5-cm left-sided Renal Artery Aneurysm using a robotic-assisted laparoscopic approach. Using the da Vinci surgical robotic system, we resected the Aneurysm, and the anterior-inferior branch of the Renal Artery was reconstructed with an end-to-end anastomosis. The operative time was 360 minutes, hospitalization length of stay was 3 days, and postoperative analgesic requirements were minimal. Follow-up imaging and functional analysis demonstrated resolution of the Aneurysm and preservation of Renal function. This technique highlights the ability of surgical robotics to expand indications for minimally invasive surgery in complex cases.
W Sandmann - One of the best experts on this subject based on the ideXlab platform.
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reconstruction for Renal Artery Aneurysm operative techniques and long term results
Journal of Vascular Surgery, 2003Co-Authors: T Pfeiffer, Lutz Reiher, K Grabitz, Benjamin Grunhage, Sebastian Hafele, Adina Voiculescu, G Furst, W SandmannAbstract:Abstract Background: Ninety-four patients (37 male, 57 female; mean age, 51.0 years) underwent reconstruction for Renal Artery Aneurysm (RAA) between 1980 and 2001. RAAs were present in 52 patients in the right kidney, in 29 patients in the left kidney, and in 13 patients in both kidneys. Eighty-three Aneurysms were located in the mainstem, 49 in a branch Artery, and four in an accessory Artery. Additional ipsilateral Renal Artery stenoses (RAS) occurred in 26 patients, bilateral RAS in 18, and contralateral RAS in six. The causes of RAA were fibromuscular dysplasia (n = 48), atherosclerosis (n = 28), dissection (n = 7), aortic coarctation (n = 5), arteritis (n = 3), giant cell arteritis (n = 1), Marfan's syndrome (n = 1), and trauma (n = 1). Seventy-five patients had hypertension, 14 were asymptomatic, and five had rupture. Indications for RAA repair concerned Aneurysms with 1 cm or more diameter in combination with risk factors of hypertension, ipsilateral and contralateral stenosis, and childbearing age in women. Without risk factors, Aneurysm size eligible for reconstruction was limited to 2 cm or more. Methods: Methods applied for reconstruction in 107 kidneys and 136 Aneurysms included Aneurysm resection with tailoring (n = 37), saphenous vein graft interposition (n = 40), tailoring and saphenous vein graft interposition (n = 7), resection and reanastomosis (n = 14), saphenous vein graft interposition and resection and reanastomosis (n = 3), polytetrafluoroethylene bypass (n = 5), and homologous vein graft interposition (n = 1). Four reconstructions had to be performed ex situ because of multiple branch involvement in three patients and rupture in one. In all patients, the concerned kidney was protected with hypothermic flush perfusion with addition of heparin and prostaglandin E 1 . Results: The overall morbidity rate was 17%, including one early graft occlusion, one partial thrombosis of the Renal Artery that necessitated fibrinolytic therapy, and a branch Artery stenosis after tailoring managed with aortoRenal bypass. The mortality in elective cases was null; one patient died of myocardial infarction 2 days after an emergency operation for ruptured RAA. The technical primary success rate was 96.8%; the secondary success rate was 98.9%. After a follow-up period from 1 to 143 months (mean, 46 months) in 83 patients (88%), 67 (81%) had patent Renal arteries free of stenoses. Among six patients with RAS, four underwent successful reoperation, five had mainstem occlusions, three had segmental Artery occlusions, and two underwent nephrectomy. Concerning the patients who underwent reoperation, percutaneous transluminal angioplasty was considered seriously but assessed as inappropriate because of long extension of stenosis or involvement of branch arteries. Hypertension was cured in 19 patients (25%) and improved in 17 (22%). Conclusion: Surgical reconstruction of RAA is a safe procedure that provides good long-term results, prevents Aneurysm rupture, cures or improves hypertension in about half of the cases, and can be achieved with autogenous reconstruction in 96%. (J Vasc Surg 2003;37:293-300.)
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reconstruction for Renal Artery Aneurysm and its effect on hypertension
European Journal of Vascular and Endovascular Surgery, 2000Co-Authors: Lutz Reiher, K Grabitz, W SandmannAbstract:Abstract Objectives: many Renal Artery Aneurysms (RAA) are diagnosed incidentally in the course of investigations for hypertension and their management is controversial. Aim: to review the results of Renal Artery reconstruction for RAA. Methods: between January 1978 and December 1998 111 RAR were performed in 81 kidneys in 71 patients. Results: fifty-nine patients were hypertensive, three had a creatinine >2.0 mg/dl and one was on dialysis. The principal underlying pathology was fibromuscular dysplasia (39) and atherosclerosis (17). The mean RAA diameter was 2.2 (range 1–15) cm overall and 3.5 (range 2–10) cm in four patients who presented with rupture. Fifty-one patients had Renal Artery stenosis. Autogenous material was used in 105 RAR. There was no 30-day mortality and the morbidity rate was 16%. The 5-year cumulative patency rate was 69%. Hypertension was cured in 25% and improved in 39%. Conclusions: RAR tested for RAA treats hypertension and reduces the risk of rupture and distal embolisation.