Retroperitoneal approach for ilio-superior mesenteric artery bypass: Technique and case series

In patients with chronic mesenteric ischemia, options for revascularization include endovascular angioplasty, stenting and open surgery, with the latter typically favored in patients who have failed or who are not candidates for endovascular intervention. Here we describe a retroperitoneal approach for open surgical revascularization in patients with a hostile abdomen. We present a case series of five patients from our institution. The median age was 72 years, the mean operative time was 143.6 minutes and 90-day mortality rate was 0. This case series demonstrates the technical feasibility, success, and safety of this approach in patients with anatomic factors that would render a traditional open surgical approach for revascularization technically difficult.