A minimally invasive approach for aortobifemoral bypass procedure

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Presentation transcript:

A minimally invasive approach for aortobifemoral bypass procedure Terézia B. Andrási, MD, PhD, Till Humbert, MD, Elke Dorner, MD, Christian F. Vahl, MD Journal of Vascular Surgery Volume 53, Issue 3, Pages 870-875 (March 2011) DOI: 10.1016/j.jvs.2010.10.075 Copyright © 2011 Society for Vascular Surgery Terms and Conditions

Fig 1 Three-dimensional preoperative computed tomographic scan (A, patient one) and magnetic resonance tomographic scan (B, patient two) showing the complex aortoiliacal occlusive disease. Journal of Vascular Surgery 2011 53, 870-875DOI: (10.1016/j.jvs.2010.10.075) Copyright © 2011 Society for Vascular Surgery Terms and Conditions

Fig 2 Schematic representation of the incisions. A, Minimal incisions (continuous lines); standard incisions (interrupted lines). B, Clamping of the aorta. Journal of Vascular Surgery 2011 53, 870-875DOI: (10.1016/j.jvs.2010.10.075) Copyright © 2011 Society for Vascular Surgery Terms and Conditions

Fig 3 A, Minimal retroperitoneal incision with exposure of the left renal vein and infrarenal aorta (patient two). B, Infraumbilical incision and placement of a drain sling to facilitate percutaneous placement of the inferior aortic clamp under 30° (patient one). Journal of Vascular Surgery 2011 53, 870-875DOI: (10.1016/j.jvs.2010.10.075) Copyright © 2011 Society for Vascular Surgery Terms and Conditions

Fig 4 A, Proximal and distal aortic clamping (patient two). B, Aortotomy and “parachute” anastomotic suture (patient two). Journal of Vascular Surgery 2011 53, 870-875DOI: (10.1016/j.jvs.2010.10.075) Copyright © 2011 Society for Vascular Surgery Terms and Conditions

Fig 5 Complete proximal end-to-side bypass anastomosis (patient two). A, Before tunneling. B, After tunneling. Journal of Vascular Surgery 2011 53, 870-875DOI: (10.1016/j.jvs.2010.10.075) Copyright © 2011 Society for Vascular Surgery Terms and Conditions

Fig 6 Limited skin incisions: 8-cm supraumbilical median incision, 1-cm infraumbilical incision, and 4-cm transversal infrainguinal groin incisions (patient four). A, Before the operation. B, After the operation. Journal of Vascular Surgery 2011 53, 870-875DOI: (10.1016/j.jvs.2010.10.075) Copyright © 2011 Society for Vascular Surgery Terms and Conditions

Fig 7 Three-dimensional postoperative computed tomographic scans. A, Intact proximal and distal anastomoses (antero-posterior view, patient one) and (B) antegrade infrainguinal and retrograde suprainguinal perfusions (antero-lateral view, patient two) are demonstrated. Journal of Vascular Surgery 2011 53, 870-875DOI: (10.1016/j.jvs.2010.10.075) Copyright © 2011 Society for Vascular Surgery Terms and Conditions