The clinical anatomy and application of right genital vein in transperitoneal laparoscopic radical ne-phrectomy
Objective To explore the anatomical features of right genital vein(RGV)and the ap-plication for location of renal pedicle vessels in transperitoneal laparoscopic radical nephrectomy(TLRN).Methods From January 2013 to December 2022,TLRN was applied for patients(125 male,72 female)with right kidney tumor in Kaifeng Central Hospital and The First Affiliated Hospital of Zhengzhou Universi-ty,and the operations were recorded on video.Key steps were as follows:RGV was detected firstly and used as a marker to locate and dissect the right renal veins(RRV)and right renal artery(RRA).Anatomi-cal features of RGV were observed including its routes,number,terminate positions,vessel diameter and distance from the end site of RGV to RRV(accurate to 0.1 mm),and the operation time,estimated bloo-ding,perioperative complications were recorded and analyzed.The categorical data were described by cases and percentage(％),and the rate was rounded as an integer.Results The TLRN was performed success-fully and RGV as a marker was used for the location of main renal pedicle vessels in 197 cases.The median operational time was 56(30-140)min,and median estimated blooding was 55(10-510)ml.A total of 209 branches of RGV were detected,including 185 cases born with single branch and 12 cases with double,the median vessel diameter of RGV was 2.4(1.0-4.8)mm.RGV run on anterior surface or in right-side of in-ferior vena cava(IVC),of which,178 branches terminated into IVC and 31 branches into RRV,the medi-an distance of the end site of RGV to RRV was 11.2(0-35.1)mm.During the operation,7 cases of vas-cular injury occurred and repaired laparoscopically.No late major bleeding or other complications of Cla-vien grade 4 or higher occured.Conclusion The anatomical presentation of RGV is more constant and the terminate position of RGV is adjacent to RRV,so RGV can be used as a marker to locate the main vessels of renal pedicle accurately in the process of right-TLRN.
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