Total laparoscopic bypass for aortoiliac occlusive lesions: 93-case experience Marc Coggia, MD, Isabelle Javerliat, MD, Isabelle Di Centa, MD, Giovanni.

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Presentation transcript:

Total laparoscopic bypass for aortoiliac occlusive lesions: 93-case experience Marc Coggia, MD, Isabelle Javerliat, MD, Isabelle Di Centa, MD, Giovanni Colacchio, MD, Jean Pascal Leschi, MD, Michel Kitzis, MD, Olivier A. Goëau-Brissonnière, MD, PhD, Journal of Vascular Surgery Volume 40, Issue 5, Pages 899-906 (November 2004) DOI: 10.1016/j.jvs.2004.08.013 Copyright © 2004 The Society for Vascular Surgery Terms and Conditions

Fig 1 Drawing (A) and operative picture (B) show peritoneal incision in left paracolonic gutter and dissection in line of Toldt fascia. Journal of Vascular Surgery 2004 40, 899-906DOI: (10.1016/j.jvs.2004.08.013) Copyright © 2004 The Society for Vascular Surgery Terms and Conditions

Fig 2 Operative picture shows aortic exposure after left retrocolonic dissection. Arrow, Left renal vein; dotted arrow, left kidney. Journal of Vascular Surgery 2004 40, 899-906DOI: (10.1016/j.jvs.2004.08.013) Copyright © 2004 The Society for Vascular Surgery Terms and Conditions

Fig 3 Drawing (A) and operative picture (B) show left retrorenal approach to abdominal aorta for suprarenal clamping. Arrow, Left renal artery. Journal of Vascular Surgery 2004 40, 899-906DOI: (10.1016/j.jvs.2004.08.013) Copyright © 2004 The Society for Vascular Surgery Terms and Conditions

Fig 4 Operative pictures showing proximal aortic clamping (A) and distal aortic clamping (B). C, Drawing shows that laparoscopic clamps stabilize the left mesocolon. Journal of Vascular Surgery 2004 40, 899-906DOI: (10.1016/j.jvs.2004.08.013) Copyright © 2004 The Society for Vascular Surgery Terms and Conditions

Fig 5 Operative pictures show performance of proximal aorta-prosthesis anastomosis (A) and final aspect after aortic unclamping (B). Journal of Vascular Surgery 2004 40, 899-906DOI: (10.1016/j.jvs.2004.08.013) Copyright © 2004 The Society for Vascular Surgery Terms and Conditions

Fig 6 Operative pictures show repositioning of the left mesocolon at the end of the procedure (A) and the small bowel, which lies over it and maintains it in place (B). Journal of Vascular Surgery 2004 40, 899-906DOI: (10.1016/j.jvs.2004.08.013) Copyright © 2004 The Society for Vascular Surgery Terms and Conditions

Fig 7 Indications for total laparoscopic aortoiliac occlusive disease repair. PTA, Percutaneous transluminal angioplasty; Ext. CFA, extension to common femoral artery. Journal of Vascular Surgery 2004 40, 899-906DOI: (10.1016/j.jvs.2004.08.013) Copyright © 2004 The Society for Vascular Surgery Terms and Conditions