Robot-assisted laparoscopic aortobifemoral bypass for aortoiliac occlusive disease: A report of two cases

Abstract

This article describes the use of robotic technology in laparoscopic aortobifemoral bypass grafting. In two patients with disabling intermittent claudication on the basis of severe aortoiliac occlusive disease, laparoscopic aortobifemoral bypass grafting was performed with a proximal end-to-side anastomosis constructed with robotic arms that had been mounted on the operating table and were controlled from a separate console. No complications occurred. Operating times were 290 and 260 minutes, and aortic anastomosis times were 48 and 37 minutes, respectively. Blood loss was less than 200 mL in both cases. A normal diet was resumed on the second postoperative day, and the patients were discharged home on postoperative days 4 and 6. To our knowledge, this is the first report on robot-assisted laparoscopic aortobifemoral bypass in the world literature.

Clinical applications of robotic technology in vascular and endovascular surgery

“…The first report on robot-assisted laparoscopic aortic surgery was published in 2002; Wisselink et al used the Zeus robotic system to construct the proximal aortic anastomosis of an aortobifemoral bypass from a console remote from the operating table in two patients with aortoiliac occlusive disease. 21 Our systematic search of the literature identified nine studies reporting on robot-assisted laparoscopic surgery for infrarenal aortic pathologies. [21][22][23][24][25][26][27][28][29] They are either case reports or case series, and after excluding publications with duplicate cases, four papers reporting on a total of 162 patients remained (Tables I and II).…”

Minimal invasive und simultan offene und endovaskuläre Gefäßeingriffe

“…Wegen ihrer geringeren Wundkomplikationen und besseren kosmetischen Ergebnisse verdient sie eine größere Bedeutung in der Koronarund peripheren Bypasschirurgie [2,10,12,23,24]. Eine andere Situation wird sich einstellen, wenn durch die Entwicklung neuerer laparoskopischer Nahttechniken und den Einsatz von Operationsrobotern eine signifikante Reduktion von Operations-und Anastomosenzeiten möglich ist [43]. Die Operation mit Hilfe einer Minilaparotomie kann deshalb als kleiner Schritt in Richtung vollständige laparoskopische Operation von aortoiliakalen Gefäßpro-zessen betrachtet werden.…”

The mechanical master–slave manipulator: an instrument improving the performance in standardized tasks for endoscopic surgery

“…Recently introduced robotic surgical systems have facilitated complex endoscopic surgery, such as microanastomoses in coronary artery bypass grafting [10,12] and aortic anastomosis [14,22]. These systems are designed to translate the surgeonÕs hand movements to the tip of the endoscopic instrument in a remote operative field using a computer-assisted master-slave system (Fig.…”