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#590 Variations in the retroperitoneal vascular anatomy – a surgical challenge
  1. R Rajagopalan Iyer,
  2. Raj Kumar Patel,
  3. Srijan Shukla and
  4. Subramanyeshwarrao Thammineedi


Introduction/Background Retroperitoneal nodal clearance forms part of the surgical procedure in treatment of various gynecologic malignancies. Variations in anatomy are not uncommon. Triphasic contrast enhanced computed tomography with vascular reconstruction helps delineate the anatomy pre-operatively. It thus serves as a roadmap for the surgery.

Methodology Retrospective data collection of patients with diagnosed endometrial/early stage ovarian cancers who had undergone retroperitoneal lymphadenectomy.

Results 55 patients underwent retroperitoneal lymphadenectomy, of which 2 were converted to laparotomy. We found 11 patients i.e. 20% had a vascular anomaly. 5 had an aberrant left lower polar renal artery, 4 had an accessory left lower polar renal vein and 1 each had infra-renal duplication of inferior vena cava and the last patient had left gonadal artery arising form polar renal artery.

Conclusion Imaging the retroperitoneum preoperatively helps identify any anatomical variations. It enhances the safety of the procedure. The reported incidence of variations in renal vein anatomy is between 1- 10% and for inferior vena cava around 3%. In our small series, the overall incidence of aberrant anatomy was 20%.

Abstract #590 Figure 1

Operative photographs and reconstucted CT images of aberrant anatomy

Disclosures NONE

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