[Video controlled, minimally invasive exposure of the abdominal aorta by retroperitoneal approach for aorto-iliac...

The morbidity and mortality rate of aortoiliac reconstruction is significant even in patients who are at low risk undergoing aortic surgery. Beyond the general extent of vascular disease, the great surgical intervention using a large vertical midline or transverse abdominal incision is also responsible for this events. To decrease the surgical stress a new minimal retroperitoneal approach was developed. To exposure the infrarenal aortic segment a 7 cm left paramedian incision is used, a special retractor and modified surgical instruments combining direct visualization of the operation field with flexible videoendoscopic control. This new approach offers the possibility to decrease the operative stress and enables complete control if serious bleeding might occur. This 'minimally invasive' approach appears to diminish the catabolic response and is hopefully associated with accelerated recovery and virtual abolition of large wound-related complications.