A highly complex operation was successfully performed at Santobono Hospital in Naples, where a Pediatric Urology team laparoscopically removed a rare aneurysm involving the right renal vein up to its confluence with the vena cava.
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The operation, made even more delicate by the compromised kidney function, was performed on a 17-year-old boy who was urgently transferred from another health facility.
The intervention was led by Professor Giovanni Di Iorio, director of the Complex Structure of Pediatric Urology of the Santobono, supported by his multidisciplinary team and the anesthesiology team.
The operation, the doctors explain, represents an exceptional clinical case: it is in fact the first documented operation in the world of laparoscopic correction of this type of aneurysm in pediatric-adolescent age. According to a review of the scientific literature, similar cases recorded globally would be just ten, all in adult patients, and none of these with a conservative outcome for the kidney.
Unlike the experiences documented so far, the approach adopted at Santobono allowed to avoid nephrectomy thanks to a plastic surgery of the renal vein, thus safeguarding the function of the organ. The use of laparoscopic surgery also guaranteed a quicker post-operative recovery, with less pain and a return to normal activities in a shorter time.
“Due to the position of the aneurysm and its size, it was an extremely complex operation,” Di Iorio explained. “We chose an advanced minimally invasive approach and, thanks to the experience gained by our team, we guaranteed the patient an effective and safe solution.”
“We saved a kidney that would have been removed elsewhere: this is the future of pediatric surgery.”
Prof. Giovanni Di Iorio, Director of Pediatric Urology – Santobono
Satisfaction also from the general director of AORN Santobono-Pausilipon, Rodolfo Conenna: "Adolescence is often a gray area between pediatrics and adult medicine. This is why we are committed to expanding the healthcare offering with dedicated and highly specialized pathways for patients up to 18 years of age".
The young patient, currently in excellent clinical conditions, will be discharged in the next few days and will continue his treatment through specialist monitoring aimed at ensuring full recovery of renal function.
What is a renal vena cava aneurysm?
A venous aneurysm is an abnormal dilation of a vein, and when it involves the renal vein (which drains blood from the kidney) and the inferior vena cava (the main vein of the body that collects blood from the lower limbs and abdominal organs), can become extremely dangerous.
In the case treated at Santobono, the aneurysm caused a severe narrowing of renal venous flow, with the risk of irreversible kidney damage and systemic complications, such as thrombosis or embolisms.
Rarity of the case:
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Only 10 cases similar described in scientific literature worldwide, all in adult patients.
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There is no precedent in which, in the presence of a similar obstruction, it has been possible save the kidney.
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First time in the world that the surgery is performed with Minimally invasive laparoscopic technique in adolescence.
Because it's important?
The success of the intervention represents an important milestone for the pediatric urological surgery and opens new perspectives for the treatment of rare and complex pathologies even in the youngest, reducing invasiveness and increasing the chances of preserving organ functionality.
Article published on 17 April 2025 - 13:08
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It is truly incredible that such a complicated operation was done successfully. It is important that we pay attention to these rare cases, especially at a young age, to save the health of the boys and their organs.