Celiac artery compression syndrome managed by laparoscopy

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Presentation transcript:

Celiac artery compression syndrome managed by laparoscopy Paolo Baccari, MD, Efrem Civilini, MD, Laura Dordoni, MD, Germano Melissano, MD, Roberto Nicoletti, MD, Roberto Chiesa, MD Journal of Vascular Surgery Volume 50, Issue 1, Pages 134-139 (July 2009) DOI: 10.1016/j.jvs.2008.11.124 Copyright © 2009 Society for Vascular Surgery Terms and Conditions

Fig 1 Position of the surgeon during the laparoscopic procedure. The camera is inserted through an access above the umbilicus. Inset, The positions of the four ports are shown: A, camera; B, operating ports; C, retractor. When a fifth port was needed, it was inserted in the left flank. Journal of Vascular Surgery 2009 50, 134-139DOI: (10.1016/j.jvs.2008.11.124) Copyright © 2009 Society for Vascular Surgery Terms and Conditions

Fig 2 A, The median arcuate ligament is divided by coagulating hook (arrow). B, The diaphragmatic aspect of the aorta is completely exposed. Journal of Vascular Surgery 2009 50, 134-139DOI: (10.1016/j.jvs.2008.11.124) Copyright © 2009 Society for Vascular Surgery Terms and Conditions

Fig 3 A three-dimensional reconstruction of the aorta and its main branches in patient 8 shows the extrinsic compression to the celiac trunk during expiration (arrow). Journal of Vascular Surgery 2009 50, 134-139DOI: (10.1016/j.jvs.2008.11.124) Copyright © 2009 Society for Vascular Surgery Terms and Conditions

Fig 4 A three-dimensional aortic reconstruction of patient 8 (Fig 3), after laparoscopic release of the median arcuate ligament, shows good patency of the celiac trunk (arrow) at the 1-month follow-up. Journal of Vascular Surgery 2009 50, 134-139DOI: (10.1016/j.jvs.2008.11.124) Copyright © 2009 Society for Vascular Surgery Terms and Conditions