Two-stage surgery to repair a dissecting abdominal aortic aneurysm in a severely obese patient: Open bifurcated graft replacement after laparoscopic sleeve gastrectomy

• Published in: Asian journal of endoscopic surgery 2016, Vol.9 (2), p.149-151
• Main Authors: Shioi, Yoshihiro, Sasaki, Akira, Nitta, Hiroyuki, Umemura, Akira, Baba, Shigeaki, Iwaya, Takeshi, Kimura, Yusuke, Otsuka, Koki, Koeda, Keisuke, Mizuno, Masaru, Kumagai, Kazuya, Kamada, Takeshi, Mukaida, Masayuki, Okabayashi, Hitoshi
• Format: Report
• Language: English
• ISSN: 1758-5910
• DOI: 10.1111/ases.12260

With the increasing prevalence of severe obesity worldwide, surgical treatment for severely obese patients is becoming more popular. Bariatric surgery has occasionally been performed as a precursor to major operations for serious diseases to make these difficult surgeries safer for severely obese patients. We present the case of a severely obese patient with a dissected abdominal aortic aneurysm and left iliac artery aneurysm. Initially, we performed bariatric surgery on this patient to reduce perioperative risk and then subsequently performed bifurcated graft replacement. A 54-year-old man presented at our hospital for bariatric surgery before open abdominal aortic aneurysm repair. Laparoscopic sleeve gastrectomy was performed; 15 months later, the patient's weight and BMI had decreased from 139.0 kg to 97.6 kg and from 48.7 kg/m(2) to 34.2 kg/m(2) , respectively. Bifurcated graft replacement was performed safely without postoperative complications. Bariatric surgery was also effective in controlling the patient's blood pressure during the interval between surgeries.