A model for laparoscopic aortic aneurysm resection

Dion, Yves-Marie; Cardon, Alain; Gracia, Carlos; Doillon, Charles J.

doi:10.1007/s004649901067

Cited by 5 publications

(4 citation statements)

References 19 publications

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“…Although few clinical series have been published concerning the laparoscopic treatment of infrarenal AAA, 14,15 2 totally laparoscopic techniques stand out in the treatment of infrarenal AAA: the apron technique by Dion et al 16 and the retrocolic approach by Coggia et al 2 In the present study, these 2 approaches were compared in an animal model. The operative time required to complete each step of each procedure was compared as well as the learning curve for laparoscopic anastomoses between a second-year general surgery resident and a vascular surgeon.…”

Section: Discussionmentioning

confidence: 95%

Totally Laparoscopic Aortic Surgery: Comparison of the Apron and Retrocolic Techniques in a Porcine Model

Huynh

Elkouri

Beaudoin

et al. 2007

Vasc Endovascular Surg

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This study evaluated the learning curve for a second-year general surgery resident and compared 2 totally laparoscopic aortic surgery techniques in 10 pigs: the transretroperitoneal apron approach and the transperitoneal retrocolic approach. Five end points were compared: success rate, percentage of conversion, time required, laparoscopic anastomosis quality, and learning curve. The first 3 interventions required an open conversion. The last 7 were done without complications. Mean dissection time was significantly higher with the apron approach compared with the retrocolic approach. The total times for operation, clamping, and arteriotomy time were similar. All laparoscopic anastomoses were patent and without stenosis. The initial learning curve for laparoscopic anastomosis was relatively short for a second-year surgery resident. Both techniques resulted in satisfactory exposure of the aorta and similar mean operative and clamping time. Training on an ex vivo laparoscopic box trainer and on an animal model seems to be complementary to decrease laparoscopic anastomosis completion time.

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Section: Discussionmentioning

confidence: 95%

Totally Laparoscopic Aortic Surgery: Comparison of the Apron and Retrocolic Techniques in a Porcine Model

Huynh

Elkouri

Beaudoin

et al. 2007

Vasc Endovascular Surg

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“…Among the various approaches currently described (ie, transperitoneal vs retroperitoneal, AAA exclusion vs AAA endoaneurysmorrhaphy), we believe that the peritoneal apron technique, which provides an adequate exposure to the aorta with no intrusion of any peritoneal organ in the operative field, coupled with endoaneurysmorrhaphy, is the technique of choice, after our studying of animals and humans. 5,10,16 It appears that the long-term fate of the exclusion technique is uncertain. Specifically, concern exists that the excluded aneurysm may still rupture because of retrograde filling by either the inferior mesenteric artery or the lumbar arteries.…”

Section: Discussionmentioning

confidence: 99%

Totally laparoscopic abdominal aortic aneurysm repair

Dion¹,

Gracia²,

Kadi³

2001

Journal of Vascular Surgery

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Abdominal aortic aneurysm (AAA) resection is a major surgical procedure performed frequently. As a minimal access procedure, laparoscopy has been shown in the field of general surgery to improve a patient's postoperative well-being and to shorten hospital stay. The same benefits could be expected from a laparoscopic approach for AAA repair. We report what we believe to be the first totally laparoscopic AAA repair performed according to the principles of endoaneurysmorrhaphy.

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“…Poucos estudos foram feitos no sentido de avaliar prospectivamente e especificamente esse pormenor da técnica [23][24][25][26][27][28] .…”

Section: Introductionunclassified

Curva de aprendizado em cirurgia aórtica videolaparoscópica: estudo experimental em porcos

Yoshida

Rollo

et al. 2008

J. vasc. bras.

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ResumoContexto: A cirurgia videolaparoscópica (CVL) vem evoluindo como alternativa cirúrgica menos invasiva para o tratamento da doença aterosclerótica oclusiva aorto-ilíaca e do aneurisma da aorta abdominal. Poucos estudos avaliaram objetivamente a curva de aprendizado com essa técnica em cirurgia vascular.Objetivo: Avaliar objetivamente os tempos e a evolução de cada passo cirúrgico e demonstrar a exeqüibilidade dessa técnica. Métodos:Entre outubro 2007 e janeiro de 2008, dois cirurgiões vasculares iniciantes na CVL operaram, após cursos e treinamentos, seis porcos consecutivos, com dissecção aórtica e interposição de um enxerto de dácron em um segmento da aorta infra-renal abdominal, com técnica totalmente laparoscópica.Resultados: Todos os tempos cirúrgicos foram decrescentes ao longo do estudo, apresentando redução de 45,9% no tempo total de cirurgia, 85,8% no tempo de dissecção da aorta, 81,2% na exposição da aorta, 55,1% no clampeamento total, 71% na confecção da anastomose proximal e 64,9% na anastomose distal. Conclusão:O presente estudo mostrou que os resultados técnicos satisfatórios da CVL vascular ocorreram somente após longa curva de aprendizado, que foi decrescente ao longo do tempo, à medida que aumentou a experiência e vivência com os materiais e com a visão não-estereoscópica. Essa técnica pode ser realizada com perfeição por cirurgiões vasculares desde que façam cursos especializados, com treinamento em simuladores e animais, e desde que busquem constante aprimoramento a fim de conseguir resultados similares aos obtidos com a cirurgia convencional.Palavras-chave: Cirurgia videoassistida, aorta, doenças vasculares, aprendizagem, modelos animais. AbstractBackground: Laparoscopic aortic surgery (LAS) is evolving as a minimal invasive alternative technique for the treatment of abdominal aortic aneurysms and peripheral aortoiliac arterial disease. Few articles have objectively evaluated the technique learning curve in vascular surgery.

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A model for laparoscopic aortic aneurysm resection

Abstract: Laparoscopic AAA resection is feasible in this animal model, which presents similarities to human AAA.

Cited by 5 publications

References 19 publications

Totally Laparoscopic Aortic Surgery: Comparison of the Apron and Retrocolic Techniques in a Porcine Model

Totally Laparoscopic Aortic Surgery: Comparison of the Apron and Retrocolic Techniques in a Porcine Model

Totally laparoscopic abdominal aortic aneurysm repair

Curva de aprendizado em cirurgia aórtica videolaparoscópica: estudo experimental em porcos

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