Total laparoscopic abdominal aortic aneurysms repair.

Area of Science:

• Vascular Surgery
• Minimally Invasive Surgery
• Abdominal Aortic Aneurysm Treatment

Background:

• Abdominal aortic aneurysm (AAA) repair is a critical surgical procedure.
• Minimally invasive techniques are increasingly explored for AAA repair.
• Laparoscopic approaches offer potential benefits over open surgery.

Purpose of the Study:

• To describe the institutional experience with total laparoscopic abdominal aortic aneurysm (AAA) repair.
• To evaluate the feasibility and outcomes of this minimally invasive technique.

Main Methods:

• A retrospective review of 49 total laparoscopic AAA repairs performed between February 2002 and September 2004.
• Patients included 45 men and 4 women, with a median age of 73 years.
• Various laparoscopic approaches were utilized, including transperitoneal and retroperitoneal routes.

Main Results:

• The study involved implanting tube grafts in 19 patients and bifurcated grafts in 30.
• Median operative time was 290 minutes, with a median blood loss of 1800 cc.
• Mortality was 6.1%, with 18% experiencing major non-lethal complications. Graft patency was achieved in 44 patients at a median follow-up of 19 months.

Conclusions:

• Total laparoscopic AAA repair is feasible and worthwhile once the learning curve is overcome.
• The procedure is technically demanding, necessitating prior videoscopic suturing expertise.
• Experience with laparoscopic aortic surgery for aortoiliac occlusive disease is recommended before undertaking laparoscopic AAA repair.