Hand-assisted laparoscopic abdominal aortic aneurysm repair

Area of Science:

• Vascular Surgery
• Minimally Invasive Surgery
• Surgical Innovation

Background:

• Traditional open aneurysm repair carries significant morbidity.
• Laparoscopic techniques aim to reduce surgical trauma and improve patient outcomes.
• Hand-assistance in laparoscopy aims to bridge the gap between open and purely laparoscopic surgery by restoring tactile feedback.

Purpose of the Study:

• To evaluate the safety and efficacy of hand-assisted laparoscopic aneurysm resection.
• To compare outcomes of hand-assisted laparoscopic repair with conventional open surgery.
• To assess the feasibility of complex aortic procedures using this technique.

Main Methods:

• A comparative study involving 29 patients undergoing transperitoneal hand-assisted laparoscopic aneurysm resection and 19 patients undergoing conventional open repair.
• Anastomosis performed using conventional instruments through a mini-incision.
• Data collected on operating time, complications, intensive care unit (ICU) stay, postoperative hospital stay, diet resumption, and recovery time.

Main Results:

• No significant difference in complication rates between hand-assisted laparoscopic and conventional groups.
• Mean operating time was longer for the hand-assisted laparoscopic group (180 minutes) compared to the conventional group (135 minutes).
• Significantly shorter ICU stay, postoperative hospital stay, earlier diet resumption, and faster overall recovery were observed in the hand-assisted laparoscopic group.

Conclusions:

• Hand-assisted laparoscopic aneurysm resection is a safe and effective alternative to open surgery.
• The technique offers significant benefits in terms of reduced patient recovery time and hospital stay.
• It provides advantages over a total laparoscopic approach with a less steep learning curve, making it suitable for most patients with aortic disease.