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Related Experiment Videos

Totally laparoscopic abdominal aortic aneurysm repair

B A Jobe1, W Duncan, L L Swanstrom

  • 1Minimally Invasive Surgery Department, Legacy Portland Hospitals, and Oregon Health Sciences University, Portland, OR, USA.

Surgical Endoscopy
|December 31, 1998
PubMed
Summary

Laparoscopic abdominal aortic aneurysm (AAA) repair is feasible using specialized instruments. This case report demonstrates a successful laparoscopic AAA repair in an 84-year-old patient, highlighting potential for minimally invasive vascular surgery.

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Area of Science:

  • Vascular Surgery
  • Minimally Invasive Surgery
  • Laparoscopic Techniques

Background:

  • Abdominal aortic aneurysms (AAA) are prevalent, necessitating advanced surgical approaches.
  • Laparoscopic techniques are increasingly explored for complex intra-abdominal vascular reconstructions.
  • Previous animal and clinical experience informed the expansion to laparoscopic AAA repair.

Observation:

  • An 84-year-old male with a 7-cm infrarenal AAA underwent laparoscopic repair.
  • The patient had a history of coronary artery bypass grafting and moderate chronic obstructive pulmonary disease (COPD).
  • A spiral computed tomography (CT) angiogram confirmed an adequate infrarenal neck and iliac artery involvement.

Findings:

  • A completely laparoscopic transabdominal approach was utilized with eight ports.

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  • Proximal and distal control were achieved, and the aneurysm was excluded using endoscopic stapling devices.
  • Aortobiiliac reconstruction was performed with a bifurcated Dacron graft; operative time was 7 hours with 1000 ml blood loss.

    • Implications:

    • This case demonstrates the possibility of laparoscopic AAA repair with specialized vascular instrumentation.
    • The patient achieved early ambulation and had no complications at 6-month follow-up.
    • Laparoscopic AAA repair is technically demanding and time-consuming, requiring further evaluation for its definitive role in vascular surgery.