Experimental laparoscopic aortobifemoral bypass with end-to-side aortic anastomosis

The goal of this animal experiment was to demonstrate the feasibility of laparoscopic end-to-side aortic anastomosis, which is mandatory in certain cases presenting with aortoiliac occlusive disease. Six piglets were submitted to laparoscopic approach of the aortoiliac vessels using the "apron" technique. After clamping the infrarenal aorta with a laparoscopic Satinsky clamp, a 3-cm end-to-side laparoscopic aortic anastomosis was constructed. Mean operative and dissection times were 198 (170-240) and 92 (75-105) min, respectively, with a mean blood loss of 86 (50-120) mL. Mean preoperative and postoperative hematocrits were 38 (3448) and 38 (34-46). Aortic cross-clamp and anastomotic times were 51 (40-65) and 44 (35-60) min, respectively. No extra sutures were needed to secure the anastomoses. At autopsy, all the anastomoses were patent without stenoses. Results indicate the feasibility of laparoscopic aortobifemoral bypass with an end-to-side aortic anastomosis.