title: A technical tip for total laparoscopic type II endoleak repair.
abstract: Laparoscopy is a minimally invasive alternative for type II endoleak repair after endovascular aneurysm repair. However, control of lumbar and median sacral arteries is considered technically difficult due to the dense inflammatory tissue surrounding the aorta. We describe a technical tip that avoids close dissection of the aneurysm sac. After the transperitoneal approaches we commonly use during laparoscopic aortic surgery, the aneurysm is drawn rightward to access the plane of the anterior longitudinal ligament. This technique allows a direct exposure of the lumbar and median sacral arteries, which are all methodically dissected and ligated along the anterior wall of the spine without close dissection of the aneurysm sac. In our experience, this technical tip was always feasible and simplified laparoscopic type II endoleak repair.
authors.affiliation: Department of Vascular Surgery, Ambroise Paré University Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt, and Faculté de Médecine Paris-Ile de France-Ouest, UFR des sciences de la santé Simone Veil, Université Versailles Saint-Quentin en Yvelines, Montigny-le-Bretonneux, France.
authors.forename: Joseph
authors.initials: J
authors.lastname: Touma
authors.affiliation: Department of Vascular Surgery, Ambroise Paré University Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt, and Faculté de Médecine Paris-Ile de France-Ouest, UFR des sciences de la santé Simone Veil, Université Versailles Saint-Quentin en Yvelines, Montigny-le-Bretonneux, France.
authors.forename: Raphaël
authors.initials: R
authors.lastname: Coscas
authors.affiliation: Department of Vascular Surgery, Ambroise Paré University Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt, and Faculté de Médecine Paris-Ile de France-Ouest, UFR des sciences de la santé Simone Veil, Université Versailles Saint-Quentin en Yvelines, Montigny-le-Bretonneux, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Javerliat
authors.affiliation: Department of Vascular Surgery M.A.S., Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Colacchio
authors.affiliation: Department of Vascular Surgery, Ambroise Paré University Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt, and Faculté de Médecine Paris-Ile de France-Ouest, UFR des sciences de la santé Simone Veil, Université Versailles Saint-Quentin en Yvelines, Montigny-le-Bretonneux, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Goëau-Brissonnière
authors.affiliation: Department of Vascular Surgery, Ambroise Paré University Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt, and Faculté de Médecine Paris-Ile de France-Ouest, UFR des sciences de la santé Simone Veil, Université Versailles Saint-Quentin en Yvelines, Montigny-le-Bretonneux, France. Electronic address: mpcoggia@aol.com.
authors.forename: Marc
authors.initials: M
authors.lastname: Coggia
mesh_terms: D001014:Aortic Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography / Q000379:methods; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D004210:Dissection; D057867:Endoleak / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D057510:Endovascular Procedures / Q000009:adverse effects*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D008026:Ligation; D056888:Patient Positioning; D012086:Reoperation; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome