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Totally laparoscopic abdominal aortic aneurysm repair

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Presentation on theme: "Totally laparoscopic abdominal aortic aneurysm repair"— Presentation transcript:

1 Totally laparoscopic abdominal aortic aneurysm repair
Yves-Marie Dion, MD, MSc, FRCSC, FACSa, b, Carlos R. Gracia, MD, FACSc, Hassen Ben El Kadi, MDa  Journal of Vascular Surgery  Volume 33, Issue 1, Pages (January 2001) DOI: /mva Copyright © 2001 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

2 Fig. 1 A, Angiography showing an occluded right iliac axis. The absence of lumbar arteries suggests the possibility of an aortic aneurysm. B, The computed tomographic scan showing a 4.6-cm AAA. Journal of Vascular Surgery  , DOI: ( /mva ) Copyright © 2001 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

3 Fig. 2 Positioning of the patient and sites of trocar insertion. The patient's left side is elevated on a pillow, and the table is tilted toward the right side. Early during the procedure, the patient is placed in a 10-degree Trendelenburg's position. Pneumoperitoneum is instituted at the umbilical site. Journal of Vascular Surgery  , DOI: ( /mva ) Copyright © 2001 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

4 Fig. 3 A, The aortic clamp (long arrow ) has been placed at the level of the aneurysm neck just distal to the left renal vein (short arrow ). The proximal portion of the aneurysm mass can be seen to the left of the picture (arrowhead ). B, The aneurysm mass has been opened. The severed neck is well demonstrated (arrowhead ). The inferior portion of the aneurysm wall (short arrow ) is seen under the aneurysm clot (long arrow ). The instruments at the upper portion of the picture remove a portion of the aneurysm clot. C, The first posterior running 3-0 polypropylene suture is started. The knot is being tied. This first 20-cm suture will run on the right lateral side of the anastomosis. The second suture will run on the left side. D, The aortic anastomosis has been unclamped. The open aortic clamp is seen to the right of the picture. A portion of the aneurysm wall can be seen pushed aside by the suction device. Surgicel has been applied against the posterior portion of the anastomosis. Journal of Vascular Surgery  , DOI: ( /mva ) Copyright © 2001 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

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