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Total laparoscopic aortobifemoral bypass.
Ph Remy1, A-F Deprez, Ch D'hont
1Department of Cardio Vascular and Thoracic Surgery, Hôpital Saint-Joseph, 6060 Gilly, Hainaut, Belgium. phiremy@skynet.be
Summary
Total laparoscopic aortobifemoral bypass is feasible and safe, with operative times improving with experience. Further randomized trials are needed to compare this minimally invasive technique against conventional surgery.
Area of Science:
- Vascular Surgery
- Minimally Invasive Surgery
- Surgical Technology
Background:
- Aortoiliac occlusive disease necessitates revascularization.
- Conventional open aortobifemoral bypass carries significant morbidity.
- Laparoscopic approaches offer potential benefits in reducing surgical trauma.
Purpose of the Study:
- To evaluate the feasibility of performing total laparoscopic aortobifemoral bypass.
- To assess the safety and early outcomes of this minimally invasive technique.
Main Methods:
- A total of 21 patients with aortoiliac occlusive disease underwent laparoscopic aortobifemoral bypass.
- Data collected included operative time, cross-clamp time, blood loss, complications, and hospital stay.
Main Results:
- Median operative time was 240 minutes, decreasing with experience.
- Median blood loss was 500 ml, with one conversion to open surgery.
- Five patients experienced post-operative complications; there were no peri-operative deaths. Median hospital stay was 7 days.
Conclusions:
- Total laparoscopic aortobifemoral bypass is a safe and feasible procedure.
- A learning curve is associated with this technique.
- Larger randomized trials are recommended to establish its clinical value compared to open surgery.