A technical tip for total laparoscopic type II endoleak repair

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Presentation transcript:

A technical tip for total laparoscopic type II endoleak repair Joseph Touma, MD, Raphaël Coscas, MD, Isabelle Javerliat, MD, Giovanni Colacchio, MD, Olivier Goëau-Brissonnière, MD, PhD, Marc Coggia, MD Journal of Vascular Surgery Volume 61, Issue 3, Pages 817-820 (March 2015) DOI: 10.1016/j.jvs.2014.11.002 Copyright © 2015 Society for Vascular Surgery Terms and Conditions

Fig 1 Patient position, operating personnel, and sites of trocar insertion are illustrated. Personnel are the operating surgeon (A), first assistant for the laparoscope (B), and second assistant for instrumentation (C). Trocar sites are for the laparoscope (1), operator instruments (2 and 3), assistant instrumentation (4 and 5), and proximal aortic clamp (6). Journal of Vascular Surgery 2015 61, 817-820DOI: (10.1016/j.jvs.2014.11.002) Copyright © 2015 Society for Vascular Surgery Terms and Conditions

Fig 2 A, Scheme shows the exposition of the left lumbar arteries (LAs; dotted arrow) in the plane of the anterior longitudinal ligament (thin arrow), through a transperitoneal left retrorenal approach. Note the sympathetic nervous trunk (double arrow) parallel to the aortic sac (thick arrow). B, Intraoperative view shows the corresponding elements. Journal of Vascular Surgery 2015 61, 817-820DOI: (10.1016/j.jvs.2014.11.002) Copyright © 2015 Society for Vascular Surgery Terms and Conditions

Fig 3 A, Preoperative computed tomography scan reconstruction shows a type II endoleak (T2E) originating from both lumbar arteries (LAs) and the inferior mesenteric artery (IMA). B, Postoperative scan reconstruction shows the range of bilateral lumbar clips (thick arrow) and the IMA clip (thin arrow) in the absence of endoleak. Journal of Vascular Surgery 2015 61, 817-820DOI: (10.1016/j.jvs.2014.11.002) Copyright © 2015 Society for Vascular Surgery Terms and Conditions