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Home > Vascular Annual Meeting^® > SS22. Totally Laparoscopic Aortic Surgery...

SS22. Totally Laparoscopic Aortic Surgery: Experience in a French Academic Center

Jérôme Cau, Jean-Baptiste Ricco
Poitiers University Hospital, Poitiers, France

OBJECTIVES: The application of laparoscopic techniques for vascular procedures has been limited by factors such as difficulties in aortic exposure and anastomosis techniques, as well as the concurrent competitive progress of endovascular surgery. The purpose of this study was to review the outcomes for laparoscopic aortic interventions in the endovascular era.

METHODS: Retrospective analysis was carried out for a series of 219 patients who underwent a totally laparoscopic aortic procedure for treatment of aortic occlusive disease (AOD; n=127) or abdominal aortic aneurysm (AAA; n=80) and 12 aorto-renal bypass. This series did not include patients operated in others centers (110 aortic bypasses).

RESULTS: Mean patient age was 61 years and the sex ratio was 3 men for 1 woman. The mean operative time of procedures for AOD was 223±50 minutes, with a mean clamp time of 56±21 minutes. 3.6% of the AOD procedures had to be converted to open. For laparoscopic AAA procedures, the mean operative time was 262±57 minutes and the mean clamp time was 103±15 minutes. 8 conversions (10%) to open procedure had to be performed in this subgroup. The 30-day mortality rate was 0.9%. Overall mortality rate was 13.4% during a mean follow-up time of 16.2 months. The primary patency rate was 100%.

CONCLUSIONS: Totally laparoscopic aortic surgery is feasible and showed promising and satisfactory results in our experience. Precise indications for this kind of surgery, compared to endovascular and open surgery, remain to be determined by randomized studies. Nevertheless, it is a difficult technique. Further development will rely on effective training, advances in technique and instrumentation.

AUTHOR DISCLOSURES: J. Cau, None; J. Ricco, None.

Figure 1.