Case Report: Single-incision robotic-assisted nephrectomy and heterotopic renal autotransplantation for a large complex renal artery aneurysm.

Renal artery aneurysms (RAAs) may require complex open vascular surgery. We describe a 50-year-old female with a large, intricate right RAA involving multiple branches. Management consisted of single-incision robotic-assisted right nephrectomy, ex vivo aneurysm excision, and arterial and venous reconstruction with heterotopic kidney autotransplantation to the right iliac fossa. Following reperfusion, partial thrombosis of the reconstructed branches occurred, which was successfully revised using reconstruction with the patient's right internal iliac artery. Postoperatively, kidney function was preserved, and no complications developed. Ex vivo repair with heterotopic kidney autotransplantation may represent a safe and effective strategy in selected patients with complex RAAs.