Total laparoscopic suprarenal aortic coral reef removal

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Presentation transcript:

Total laparoscopic suprarenal aortic coral reef removal Isabelle Di Centa, MD, Marc Coggia, MD, Isabelle Javerliat, MD, Pascal Alfonsi, MD, Jean-Michel Maury, MD, Michel Kitzis, MD, Olivier Goëau-Brissonnière, MD, PhD Journal of Vascular Surgery Volume 44, Issue 1, Pages 194-197 (July 2006) DOI: 10.1016/j.jvs.2006.02.037 Copyright © 2006 The Society for Vascular Surgery Terms and Conditions

Fig 1 Intraoperative view showing laparoscopic exposure of the celiac aorta and visceral arteries through a transperitoneal left partial medial visceral rotation. Arrow, Retractor behind the pancreas; dotted arrow, divided left crus of the diaphragm; CT, celiac trunk; SMA, superior mesenteric artery; LRA, left renal artery; LRV, left renal vein. Journal of Vascular Surgery 2006 44, 194-197DOI: (10.1016/j.jvs.2006.02.037) Copyright © 2006 The Society for Vascular Surgery Terms and Conditions

Fig 2 Preoperative lateral aortogram (arrow, celiac trunk) (A) and contrast-enhanced computed tomographic scan (B) showing partial luminal filling with the calcified material. (C) Intraoperative view after coral reef removal showing the suprarenal aortic suture and infrarenal graft implantation. Dotted line, Suture line of the suprarenal aortotomy; SMA, superior mesenteric artery; LRA, left renal artery; LRV, left renal vein. Journal of Vascular Surgery 2006 44, 194-197DOI: (10.1016/j.jvs.2006.02.037) Copyright © 2006 The Society for Vascular Surgery Terms and Conditions

Fig 3 Preoperative computed tomographic scan view showing the celiac coral reef protruding into the visceral arteries (A) with occlusion of the main right renal artery (B). (C) Intraoperative view showing removal of the coral reef with laparoscopic grasping forceps. Arrow, Proximal supraceliac aortic clamp; dotted arrow, celiac trunk controlled with a bulldog clamp. Journal of Vascular Surgery 2006 44, 194-197DOI: (10.1016/j.jvs.2006.02.037) Copyright © 2006 The Society for Vascular Surgery Terms and Conditions