Laparoscopic para-aortic lymphadenectomy in cases of retro-aortic left renal vein

Abstract

Vascular anomalies involving the renal veins are rare; the overall prevalence for a retro-­ aortic renal vein is 3%. A patient diagnosed with serous ovarian cancer underwent a laparoscopic surgical restaging, including hysterectomy, omentectomy, peritoneal biopsies, bilateral pelvic lymphadenectomy, and para-aortic lymphadenectomy. After identification of the right ureter, inferior vena cava, and aorta, the para-caval lymph node dissection was completed. The left lumbo-­ aortic retroperitoneal spaces were dissected, but the left renal vein was not found while the left renal artery was identified. Further inspection revealed the retro-­ aortic left renal vein (Figures 1 and 2). The vein converged into the inferior vena cava after passing under the abdominal aorta immediately above the common iliac vein bifurcation. No other vascular anomalies were found . The surgery was uneventful. An accurate identification of the renal vessels is crucial when performing surgical procedures around the inferior vena cava due to the significant risk of vascular injury in cases of vascular anomalies.