569 Robotic Kidney Autotransplant: Taming Monster Renal ArteryAneurysm

Dr. Nipun Bansal

A 66-year-old male with presented with a rare constellation of conditions—large complex left renal artery aneurysm with failed prior endovascular stenting, adrenal myelolipoma, and a renal calculus. Conventional options posed risks of nephrectomy, threatening renal preservation. We adopted a multifaceted, minimally invasive solution: robotic left nephrectomy with adrenalectomy, bench RIRS with vascular reconstruction, followed by robotic renal autotransplantation. This approach ensured complete aneurysm excision, calculus clearance, and adrenal tumor removal while preserving renal function. The use of an Alexis port allowed atraumatic kidney handling, and precise vascular reconstruction optimized graft outcomes. Postoperatively, the patient achieved normal renal function, graft patency, and hypertension resolution. The innovation lies in combining proper preoperative planning, robotic surgery with bench reconstruction, RIRS and autotransplant in a single sitting, offering a safe, kidney-preserving solution for complex life-threatening urological challenge traditionally managed by a multidisciplinary team with more morbid open procedures.

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