Laparoscopic Surgery in the Management of Complex Aortic Disease: Techniques and Lessons Learned

Laparoscopic vascular surgery must be assessed in the context of both open and endovascular interventions. The development of improved laparoscopic equipment and endoscopic techniques makes performance of laparoscopy easier, but endovascular interventions still hold wide appeal because they are mini...

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Bibliographic Details
Published in:Vascular 2009-12, Vol.17 (3_suppl), p.119-128
Main Authors: Cagiannos, Catherine, Kolvenbach, Ralf R.
Format: Article
Language:English
Subjects:
Aortic Aneurysm, Abdominal - complications
Aortic Aneurysm, Abdominal - pathology
Aortic Aneurysm, Abdominal - surgery
Aortic Rupture - etiology
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation - adverse effects
Blood Vessel Prosthesis Implantation - instrumentation
Blood Vessel Prosthesis Implantation - methods
Clinical Competence
Evidence-Based Medicine
Foreign-Body Migration - etiology
Humans
Iliac Aneurysm - complications
Iliac Aneurysm - pathology
Iliac Aneurysm - surgery
Laparoscopy - adverse effects
Prosthesis Design
Prosthesis Failure
Reoperation
Risk Assessment
Treatment Outcome
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Summary:Laparoscopic vascular surgery must be assessed in the context of both open and endovascular interventions. The development of improved laparoscopic equipment and endoscopic techniques makes performance of laparoscopy easier, but endovascular interventions still hold wide appeal because they are minimally invasive and are easier to master by vascular surgeons. Despite decreased morbidity and recovery time, endovascular interventions have inferior durability and higher reintervention rates when compared with open aortoiliac interventions. In particular, after endovascular aneurysm repair, patients need lifelong surveillance because there is potential for delayed endoleaks, aortic neck dilatation, graft migration, and ongoing risk of aneurysmal rupture. These limitations of endovascular therapy are the impetus behind the pursuit of other minimally invasive techniques, such as laparoscopy, in vascular surgery. Currently, two evolving laparoscopic approaches are available for abdominal vascular surgery: total laparoscopic aortic surgery and hybrid techniques that combine laparoscopy with endovascular techniques to treat failing endografts.
ISSN:1708-5381
1708-539X
DOI:10.2310/6670.2009.00061