Vascular anomalies found by retroperitoneal laparoscopic para-aortic lymphadenectomy
Epublication WebSurg.com, Jan 2015;15(01). URL: http://websurg.com/doi/vd01en4428
The retroperitoneum is an area of great interest in gynecologic oncology. The knowledge of the anatomy and potential vascular anomalies, which can be found, can help prevent complications. The retroperitoneal vascular anomalies are often asymptomatic. Their prevalence ranges between 2.4 and 30% according to the published literature. Its diagnosis includes imaging techniques or it can be made during surgery. Although the presence of these variations may go unnoticed, different potential complications can be devastating (e.g., hemorrhage, loss of organs or even death). In this video, the authors demonstrate some variations of retroperitoneal vessels diagnosed during the practice of retroperitoneal laparoscopic para-aortic lymphadenectomy performed in gynecologic cancer patients (advanced cervical cancer, endometrial carcinoma, and ovarian cancer in early stages). In our case series of 60 procedures performed during 2011, 2012, and 2013, vascular anatomical anomalies are 33.33% (20 cases) and all of them were diagnosed during surgery. First, the anomaly of the renal vascular territory (arterial or venous) was the most frequent, followed by anomalies which affect gonadal vessels, and finally by great vessel anomalies.