Total laparoscopic aortobifemoral bypass.
OBJECTIVE
To assess the feasibility of aortobifemoral bypass by a laparoscopic approach.


METHODS
During November 2002 through July 2003 a total of 21 patients with aorto-iliac occlusive disease underwent total laparoscopic aortobifemoral bypass surgery.


RESULTS
The median operative time was 240 (range 150-420) min with a median aortic cross-clamp time of 60 (30-120) min. Operating time was reduced with experience. The median blood loss was 500 (100-2500) ml. One conversion to open surgery for acute dilation of the small bowel was necessary. Post-operative complications occurred in five patients (coagulation problems, disseminated intravascular coagulation secondary to thrombosis of the left limb, cerebro-vascular accident, dyspnoea, lymph leak) and there was no peri-operative death. Median hospital stay was 7 (5-30) days.


CONCLUSIONS
Aorto-bifemoral bypass using a total laparoscopic approach can be performed safely. As all new techniques, a learning curve is observed. This new technique should be evaluated in a larger randomised trial to assess its clinical value in comparison to conventional surgery.
Remy
Ph
P
Department of Cardio Vascular and Thoracic Surgery, Hôpital Saint-Joseph, 6060 Gilly, Hainaut, Belgium. phiremy@skynet.be
Deprez
A-F
AF
D'hont
Ch
Ch
Lavigne
J-P
JP
Massin
H
H
D000328:Adult; D000368:Aged; D001011:Aorta / Q000601:surgery; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005263:Femoral Artery / Q000601:surgery; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome