A new technique for laparoscopic aortobifemoral grafting in occlusive aortoiliac disease

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Laparoscopic  aortobifemoral  grafting allows to cure aortoiliac disease

Methods: The technique is the result of 6 years of in vitro and animal experimentation. It also represents the end result of prior clinical research with laparoscopy-assisted aortoiliac surgery and totally laparoscopic retroperitoneal aortobifemoral bypass grafting. The technique consists of the creation of a flap of retroperitoneum that is used to separate the intraperitoneal organs from the content of the retroperitoneal cavity. Surgery can then be conducted with no intrusion of any intraabdominal organ into the operative field. Another advantage is that the pneumoperitoneum is equally distributed among the two cavities. A conventional aortobifemoral bypass procedure is then performed with laparoscopic instrumentation.

Results: The described technique has been performed in three patients to date. The patients' intraoperative blood loss did not exceed 500 ml, and no complication arose. The intraoperative need for crystalloids was of the order of 3 L (almost half the quantity usually administered). The patients' analgesia requirement was low in these patients, and return to walking was rapid. They were sent home between the fourth and sixth postoperative days.

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