| Hand-assisted laparoscopic surgery for abdominal aortic aneurysm. | |
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MedLine Citation:
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PMID: 15361948 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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There is a trend toward the use of minimally invasive surgery and limited incision for the surgical repair of abdominal aortic aneurysm (AAA). Conventional AAA repair is performed with a large laparotomy wound and uses either a transperitoneal or retroperitoneal approach. Due to the older age of this patient population, they often suffer more from the surgical wound, require prolonged hospital stay and have a slower recovery. We describe the use of hand-assisted laparoscopic surgery for grafting of a 5.5-cm infrarenal AAA identified by computed tomography scan. The operator inserted the left hand with a Pneumo Sleeve device in the abdomen through a 7-cm midline supraumbilical incision for laparoscopic surgery. Using the left hand and laparoscopic instruments to do the surgery provided control over the operation and sensation of touch. At the completion of the laparoscopic dissection, the first Clawford clamp was applied above the aortic bifurcation through the laparoscopic incision. The second Clawford clamp was applied below the renal arteries through the midline laparotomy incision. After cross-clamping the AAA, the aneurysm was incised, the clot removed, and lumbar bleeding points were oversewn with 3-O prolene suture. Then, the aneurysmal segment was grafted with a Dacron prosthesis using conventional suturing technique. The patient was extubated 3 hours after the operation, stayed in the intensive care unit for 1 night and was discharged 7 days later. He resumed oral intake on the postoperative day 1. There were no complications. This case illustrates that hand-assisted laparoscopic surgery for AAA can allow quick recovery of bowel function, quick progression to regular diet, short length of hospital stay, and probably a reduction in the total cost of care. |
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Authors:
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Kuan-Ming Chiu; Tse-Yu Lin; Pi-Hsin Huang; Shu-Hsun Chu |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Journal of the Formosan Medical Association = Taiwan yi zhi Volume: 103 ISSN: 0929-6646 ISO Abbreviation: J. Formos. Med. Assoc. Publication Date: 2004 Sep |
Date Detail:
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Created Date: 2004-09-13 Completed Date: 2004-11-02 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 9214933 Medline TA: J Formos Med Assoc Country: China (Republic: 1949- ) |
Other Details:
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Languages: eng Pagination: 724-6 Citation Subset: IM |
Affiliation:
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Department of Cardiovascular Surgery, Cardiovascular Center, Far-Eastern Memorial Hospital, Pan-Chiao, Taipei County, Taiwan. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aortic Aneurysm, Abdominal / surgery* Humans Laparoscopy / methods* Male |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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