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Based on a review of the literature and 241 cases of abdominal aortic aneurysm (AAA) operated at the Mannheim Surgical Clinic, the progress and pitfalls in the management of this lesion are discussed. Progress in diagnosis is based on noninvasive imaging procedures, e.g., ultrasound, which lead to the detection of more aneurysms before they rupture. Ultrasound also plays a role in the observation of small asymptomatic aneurysms in high‐risk patients, helping some to avoid operation as well as rupture. Progress in the treatment of AAA means simplification: rapid clamping of the aorta in case of rupture, minimal dissection, and aneurysmal repair with straight‐tube interposition by the inlay technique. The pitfalls of “trash foot,” colon, or renal ischemia as well as graft infection can be mostly circumvented by observance of technical detail. In this series, the mortality following repair of asymptomatic AAA was 3.7%; for symptomatic aneurysms, it was 8%; and for ruptured aneurysms, it amounted to 55%.

Acute aseptic disturbances of wound healing include seromas, haematomas, marginal necroses and wound rupture. Since there are no reliable figures available concerning the incidence of the first three, a prospective clinical trial was carried out. The incidence of aseptic disturbances was 7.6 %, the rate of wound rupture 0.7 %. This complication rate can best be lowered by paying attention to the risk factors, which are in part to be found in the patient himself, but also in the surgical technique and ancillary therapy.