Total laparoscopic aortic repair for occlusive and aneurysmal disease: first 95 cases.
OBJECTIVE
To analyze the outcome of our preliminary experience with total laparoscopic aortic repair in patients with occlusive or aneurysmal disease.


METHODS
From September 2002 to April 2005, we performed 95 consecutive total laparoscopic aortic repair procedures including 72 for aortic occlusive disease (group A) and 23 for abdominal aortic aneurysm (group B).


RESULTS
In group A, mean operating time was 216+/-50 min with a mean clamp time of 57+/-21 min and surgical conversion was required in two cases (2.7%). No postoperative death occurred but there were three postoperative complications necessitating re-intervention (retroperitoneal hematoma, embolic ischemia, and early prosthetic infection). Mean duration of hospitalization was 8 days (range, 5-42 days). All grafts were patent at 2 months. In group B, mean operating time was 251+/-57 min with a mean clamp time of 101+/-15 min and surgical conversion was required in seven cases (30%). There was one postoperative death (4.3%) due to pulmonary embolism and one non-fatal complication (retroperitoneal hematoma). Mean duration of hospitalization was 6.4 days (range, 4-12 days). All grafts were patent at 2 months.


CONCLUSIONS
Total laparoscopic repair is feasible and safe for occlusive and aneurysmal aortic disease. Operators must acquire technical skills using simulators.
Cau
J
J
Vascular Surgery Department, University Hospital, Poitiers, France.
Ricco
J-B
JB
Marchand
C
C
Lecis
A
A
Habbibeh
H
H
Guillou
M
M
Febrer
G
G
Bossavy
J-P
JP
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D001011:Aorta / Q000473:pathology / Q000601:surgery*; D017544:Aortic Aneurysm, Abdominal / Q000473:pathology / Q000601:surgery*; D001157:Arterial Occlusive Diseases / Q000473:pathology / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D004502:Education, Medical, Continuing; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D012086:Reoperation; D014654:Vascular Patency