Laparoscopic end-to-end aortobifemoral bypass with reimplantation of the inferior mesenteric artery

Abstract

Laparoscopic IMA reimplantation during laparoscopic aortobifemoral bypass is feasible.

Total laparoscopic abdominal aortic aneurysm repair with reimplantation of the inferior mesenteric artery

“…Dion et al 14 reported IMA reimplantation in a porcine model. In a preliminary study we demonstrated that laparoscopic reimplantation of the IMA in six cadavers was feasible (unpublished data).…”

Current modifications to totally laparoscopic “apron technique”

“…The difference in our modified procedure is that the "peritoneal apron" is totally created from a right-sided intraabdominal approach and made shorter, which is less time-consuming. 2 The posterior retroperitoneal dissection we used to do through trocar 5 proved tedious. Moreover, we noted that this dissection also caused the ureter to be lifted up along its entire length, with potential adverse effects, eg, ischemic stricture, leading to early transient postoperative hydronephrosis.…”

Intestinal retractor for transperitoneal laparoscopic aortoiliac reconstruction

“…Like some other surgical teams [1, 7], we performed initial experimentN studies on animals, beginning in 1996, to learn more about the laparoscopic surgical technique and gain more familiarity with the main difficulties associated with the transperitoneal, retroperitoneal, and thoracic approaches [2,4,9,13]. At the same time, we developed taparoscopic vascular instruments that were designed to solve the specific problems that we had encountered when performing these new procedures.…”

“…The mean postoperative hospital stay was 6 days (range, [3][4][5][6][7][8][9][10][11][12][13], and six of the eight patients left the hospital on or before day 6.…”

“…Since 1996, we have conducted several experimental studies in order to improve our skills in laparoscopy, determine the respective advantages and drawbacks of the different surgical approaches, and develop specific laparoscopic vascular instruments [2,4,9,13]. In a comparative study in a pig model, we *bund that both the retroperitoneal and the transperitoneal approach were feasible; however, the latter appeared simpler and offered better exposure of the right aortic wall, the right lumbar and renal arteries, and the right lilac axis [2,4].…”