[Posterolateral retroperitoneal approach and exclusion technique in therapy of infrarenal aortic aneurysm: initial...

Although the infrarenal aorta is a retroperitoneal structure, the surgical access has been transperitoneal especially when dealing with infrarenal aneurysms. After the opening of the sack a tube-or bifurcated graft is implanted. With the posterolateral retroperitoneal (RP) approach described by G.M. Williams in 1980 access to the aorta can be gained without opening the peritoneal cavity. With the non resective exclusion technique the intraoperative blood loss is minimized. This method is routinely used in Albany N.Y. for the treatment of infrarenal aneurysms. We describe here our first experiences with 44 RP excluded aortic aneurysms. Despite the small number of cases we can confirm the advantages described in the larger series of Sicard et al. and Leather and Shah: the RP approach and the exclusion technique can be routinely used for infrarenal aneurysms. It is associated with a smoother and shorter postoperative period (8 to 10 days).