Superior Mesenteric Artery Injury during Robotic Radical Nephrectomy: Scenarios and Management Strategies

Autor: Aref S. Sayegh, Luis G. Medina, Anibal La Riva, Laura C. Perez, Jaime Poncel, Edward Forsyth, Giovanni E. Cacciamani, Ben Challacombe, Michael Stifelman, Inderbir Gill, Rene Sotelo
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Journal of Clinical Medicine, Vol 12, Iss 2, p 427 (2023)
Druh dokumentu: article
ISSN: 12020427
2077-0383
DOI: 10.3390/jcm12020427
Popis: Injury to the superior mesenteric artery (SMA) is a rare, underreported, and potentially devastating complication. This study aims to propose a systematic workup to describe how to prevent and manage SMA injury in a standardized stepwise manner. Three different instances of intraoperative injury to the SMA are described in an accompanying video. All three occurred when the SMA was misidentified as the left renal artery during left robotic radical nephrectomy. In the first case, the SMA was mistakenly identified as the renal artery, but after further dissection, the real renal artery was identified and SMA injury was prevented. In the second case, the SMA was clipped and the real left renal artery was subsequently identified, requiring clip removal. In the third case, the SMA was clipped and completely transected, requiring prompt repair by vascular surgery with a successful outcome. This study aims to propose a systematic workup to describe how to prevent and manage SMA injury in a standardized stepwise manner. The proper anatomic recognition of the SMA may prevent its injury. Intraoperative SMA injury should be promptly identified and repaired to avoid its devastating consequences.
Databáze: Directory of Open Access Journals
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