Laparoscopic aortorenal bypass: a feasibility study.
OBJECTIVE
To demonstrate the technical feasibility of laparoscopic aortorenal bypass in an acute porcine model.


METHODS
An aorta-to-left renal artery bypass using an interposition Dacron graft was performed in five pigs. Intracorporeal laparoscopic free-hand suturing and knot-tying were employed exclusively. Renoprotective in-situ regional hypothermia was achieved intracorporeally by infusing ice-cold heparinized saline into the renal artery using a balloon catheter.


RESULTS
The mean total surgical time was 325 minutes, and the mean renal ischemia time was 61 minutes. The end-to-side graft-to-aorta and end-to-end graft-to-renal artery anastomosis times were 34 minutes and 40 minutes, respectively. The mean estimated blood loss was 66 mL. On revascularization, prompt reperfusion of the kidney and Doppler-confirmed pulsation of the renal artery was noted. Graft patency was confirmed on autopsy.


CONCLUSIONS
Laparoscopic aortorenal bypass is feasible. This study represents the initial report in the literature. A long-term animal survival study is planned.
Hsu
T H
TH
Department of Urology, and Minimally Invasive Surgery Center, Cleveland Clinic Foundation, Ohio 44195, USA.
Gill
I S
IS
Sung
G T
GT
D000818:Animals; D001012:Aorta, Abdominal / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D010535:Laparoscopy / Q000379:methods*; D012077:Renal Artery / Q000601:surgery*; D012078:Renal Artery Obstruction / Q000601:surgery; D013552:Swine; D013997:Time Factors