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• W2261359319 abstract "Background: The aim of this video is to show how to perform step-by-step technique of laparoendoscopic single site surgery (LESS) transumbilical transmesocolic approach for treatment of nutcracker syndrome. Material and Methods: An 18-year-old man with lumbar pain, hematuria, and varicocele had a diagnosis of nutcracker syndrome with computed tomography scan. Surgical Steps: The patient was positioned in left lateral decubitus. Then, the following were performed: 3-cm intraumbilical incision; location of Alexis retractor; adaptation of surgical glove with two 10-mm trocars and one 5-mm trocar attached to Alexis; pneumoperitoneum with 15-mm CO2 pressure; identification of aortic pulsation; opening posterior peritoneum between duodenum and inferior mesenteric vein (IMV) with harmonic scalpel and conventional instruments; ligation and division of IMV; dissection of aorta until identification of obliterated renal vein, superior mesenteric artery (SMA), and dilated tributary veins; external suture passed in the mesentery of transverse colon to superior retraction; ligation and division of adrenal and gonadal veins with hem-o-lock clips; renal vein repair with Penrose drain; circumferential release of renal vein out of fibrotic adherence until vena cava; immediate observation of renal vein outflow restoration; measuring the length of renal vein to receive the external prosthesis; locating polytetrafluoroethylene (PTFE) tube around renal vein; fixation of the mesh in adventitia of aorta with 4-0 prolene attached with hem-o-lock clips; endoscopic confirmation of the correct placement of mesh related to vena cava, renal vein, and SMA; suturing of posterior peritoneum; and incision closure. Results: Operative time was 131 minutes. Blood loss was 50 mL. No complication was observed. Hospital stay was 22 hours. Improvement of symptoms was obtained. Time to normal activities was 2 weeks. Esthetic aspect was satisfactory. Postoperative Doppler showed normal renal vein drainage. Conclusion: LESS extravascular renal vein stent is safe and feasible to treat nutcracker syndrome. The authors have nothing to disclose. Runtime of video: 8 mins 15 secs" @default.
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• W2261359319 date "2012-04-01" @default.
• W2261359319 modified "2023-09-26" @default.
• W2261359319 title "LESS Extravascular Renal Vein Stent for Treatment of Nutcracker Syndrome: Step-by-Step Technique" @default.
• W2261359319 doi "https://doi.org/10.1089/vor.2011.0043" @default.
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