Experimental laparoscopic aortic aneurysm resection and aortobifemoral bypass

Area of Science:

• Vascular Surgery
• Minimally Invasive Surgery
• Surgical Innovation

Background:

• Abdominal aortic aneurysms pose significant surgical challenges.
• Traditional open repair can involve extensive dissection and longer recovery times.
• Minimally invasive techniques offer potential benefits for aortic aneurysm treatment.

Purpose of the Study:

• To develop and evaluate a novel laparoscopic technique for aortic aneurysm resection and aortobifemoral bypass.
• To utilize an anterior retroperitoneal approach for enhanced laparoscopic access to the aorta.
• To establish a viable animal model for further research into laparoscopic aortic surgery.

Main Methods:

• Anterior retroperitoneal approach modified for laparoscopic exposure in eight piglets.
• Placement of multiple laparoscopic ports for dissection, retraction, and instrumentation.
• Performance of laparoscopic aortobifemoral bypass with infrarenal aortic cross-clamping.
• Suturing of the aorta and vascular graft using standard surgical techniques.

Main Results:

• Successful completion of four laparoscopic aortobifemoral bypasses in an average of 4.5 hours.
• Minimal blood loss (<550 cc) achieved during the procedures.
• No mortality observed in the animal model prior to planned sacrifice.

Conclusions:

• The developed laparoscopic technique using an anterior retroperitoneal approach is feasible in a porcine model.
• This technique facilitates aortic aneurysm resection and aortobifemoral bypass with minimal complications.
• The established animal model provides a foundation for advancing laparoscopic aortic surgery in humans.