Laparoscopic-assisted Aortic Surgery

Park, Jang Sang; Im, Myoung Goo; Song, Kyo Young; Park, Sun Cheol; Yang, Keun Ho

Abstract

Since the initial success and widespread acceptance of laparoscopic cholecystectomy (1), the application of this laparoscopic technique to vascular surgery has been somewhat limited. However, after laparoscopic techniques were first applied to vascular surgery in 1993 (2), many technological developments for this procedure have been accepted. Laparoscopy confers three major benefits: better visualization of the aorta, less bowel manipulation, and avoidance of hypothermia. However, advanced total laparoscopic surgery can be difficult and time-consuming, and its benefits are not yet readily apparent. Laparoscopic-assisted aortic surgery enables the surgeon to use a smaller incision and this reduces surgical trauma when compared with the conventional surgical techniques (3). The use of the HandPort device enables the surgeon to use their hands while maintaining the pneumoperitoneum; this allows the vascular surgeon to maintain the sense of touch, and to perform the aortoprosthetic anastomosis safely with use of a MultiTool instrument. Our two case reports illustrate the feasibility of laparoscopic-assisted aortic surgery via minilaparotomy.