title: Totally laparoscopic juxtarenal aortic anastomosis: an experimental study.
abstract: The surgical management of juxtarenal aneurysms necessitates suprarenal aortic clamping and control of the renal arteries. We attempted to reproduce this procedure laparoscopically. Five female piglets were submitted to a totally laparoscopic approach of the aortoiliac segment. After laparoscopic control of the renal arteries and suprarenal clamping, a 6-mm Dacron tube graft was anastomosed to the juxtarenal aorta. After the procedure, a midline laparotomy allowed verification of the patency of the renal arteries and the quality of the anastomosis. Mean operative time was 198 minutes (range, 170-240 minutes). The dissection took an average of 92 minutes (range, 75-110 minutes). The mean suprarenal aortic cross-clamp time was 46.3 minutes (range, 29.1-81.5 minutes), and the mean anastomotic time was 28.9 minutes (range, 16.5-68.1 minutes). This study demonstrates in this animal model the feasibility of juxtarenal aortic anastomosis using a laparoscopic technique. Newly designed instruments should allow a shorter clamping time in the future.
authors.affiliation: Department of Surgery, Centre Hospitalier Universitaire de Québec, Hôpital Saint-François d'Assise, Canada. dion.yves@videotron.ca
authors.forename: Yves-Marie
authors.initials: YM
authors.lastname: Dion
authors.forename: Geoffroy Warnier
authors.initials: GW
authors.lastname: De Wailly
authors.forename: Fabien
authors.initials: F
authors.lastname: Thaveau
authors.forename: Jim
authors.initials: J
authors.lastname: Gourdon
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods*; D000818:Animals; D001012:Aorta, Abdominal / Q000601:surgery*; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D004195:Disease Models, Animal; D010535:Laparoscopy / Q000379:methods*; D011093:Polyethylene Terephthalates; D012077:Renal Artery; D013552:Swine; D014656:Vascular Surgical Procedures
chemical_list: D011093:Polyethylene Terephthalates