Extraperitoneal laparoscopic aortic control with endovascular visualization of a stent-graft combination

to demonstrate the feasibility of minimally invasive approaches to the aorta using retroperitoneal laparoscopy and to clamp the aorta to give views for perfemoral aortic angioscopy.

using retroperitoneal laparoscopy facilitated by balloon dissection the authors developed a new approach to the infrarenal abdominal aorta, in six pigs, to allow control of aortic blood flow. Aortic stent-grafts were then deployed via femoral arteriotomy, and after flushing the blood from the aorta, the stent-grafts were visualized by angioscopy.

accurate positioning and patency of the stent-grafts was ascertained by direct vision angioscopy in all cases.

this series shows that extraperitoneal laparoscopic aortic dissection is feasible and direct endovascular visualization of the aortic lumen can be performed. This may find a role as an adjunct to endovascular techniques such as endovascular stent-graft placement, by aortic angioscopy following minimally-invasive aortic clamping.