Total Laparoscopic Aortobifemoral Bypass

AbstractAimTo assess the feasibility of aortobifemoral bypass by a laparoscopic approach.Material and methodsDuring November 2002 through July 2003 a total of 21 patients with aorto-iliac occlusive disease underwent total laparoscopic aortobifemoral bypass surgery.ResultsThe median operative time was 240 (range 150–420)min with a median aortic cross-clamp time of 60 (30–120)min. Operating time was reduced with experience. The median blood loss was 500 (100–2500)ml. One conversion to open surgery for acute dilation of the small bowel was necessary.Post-operative complications occurred in five patients (coagulation problems, disseminated intravascular coagulation secondary to thrombosis of the left limb, cerebro-vascular accident, dyspnoea, lymph leak) and there was no peri-operative death. Median hospital stay was 7 (5–30) days.ConclusionAorto-bifemoral bypass using a total laparoscopic approach can be performed safely. As all new techniques, a learning curve is observed. This new technique should be evaluated in a larger randomised trial to assess its clinical value in comparison to conventional surgery