Left retroperitoneal approach for aortic surgery

Wheeler, James M.

doi:10.1016/s0967-2109(02)00028-5

Cited by 1 publication

(2 citation statements)

References 7 publications

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“…Once this plane is entered, the dissection proceeds medially and anterior to the psoas muscle. 8 Vital to this approach is division of the lumbar vein, which is invariably present, connecting with the left renal vein. 9 Once divided, the left renal artery is visualized.…”

Section: The Contemporary Rp Approachmentioning

confidence: 99%

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The retroperitoneal approach to the abdominal aorta in the endovascular era

Twine

Lane

Williams

2012

Journal of Vascular Surgery

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The aim of this review was to assess the place of retroperitoneal (RP) aortic surgery for abdominal aortic aneurysms (AAAs) in the endovascular era and evaluate the evidence supporting it in preference to the more traditional transperitoneal approach. As endovascular graft technology improves, open aortic surgery is declining. AAAs unsuitable for endovascular aneurysm repair are, by definition, anatomically challenging. The RP approach is especially suited to anatomic challenges such as those posed by contemporary open AAA because it facilitates access to the suprarenal aorta. There is evidence that the RP approach reduces postoperative morbidity and length of stay compared with transperitoneal approaches. The evidence available indicates that the RP approach should be the first considered for any AAA unsuitable for endovascular aneurysm repair; however, the technique is more difficult to learn and less commonly practiced than the transperitoneal approach. Combined with a decrease in training hours in the United Kingdom, there is a real threat that the RP technique will only be performed by an ever-decreasing number of enthusiasts.

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Section: The Contemporary Rp Approachmentioning

confidence: 99%

“…The ribs and iliac crest are outlined in blue. Line 1 represents Williams' 4 original incision, and line 2represents a more contemporary incision useful for suprarenal aortic exposure 7,8.…”

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confidence: 99%