Document Detail


Totally laparoscopic aortobifemoral bypass grafting in an experimental model: description of technique with initial surgical results.
MedLine Citation:
PMID:  8733868     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Our aim was to examine the feasibility of a totally laparoscopic insertion of a bifurcated aortofemoral bypass graft in a canine model and to compare the surgical results with those in control animals undergoing standard grafting and laparoscopic-assisted bypass procedures. Using a six-port approach, we exposed and cross clamped the aorta, tunneled a bifurcated Dacron graft, and performed an end-to-end aortic anastomosis while maintaining pneumoperitoneum by means of CO2. Proximal anastomoses were performed with 4/0 double-ended continuous Prolene sutures and distal anastomoses were performed through standard groin incisions. Total operating and aortic cross-clamp times were measured as was the total blood loss for each procedure. Clinical outcome was also documented. Eight female laboratory-bred hounds underwent successful totally laparoscopic aortobifemoral bypass grafting, eight underwent "open" grafting, and eight underwent laparoscopic-assisted bypass. Mean operating time was 193 minutes in the animals undergoing totally laparoscopic insertion vs. 156 minutes in the open group and 180 minutes in the laparoscopic-assisted group. Aortic cross-clamping time was also significantly longer at 87 minutes vs. 43 minutes (p < 0.001) in the totally laparoscopic group, but blood loss was less. All eight laparotomy and laparoscopic-assisted dogs were still alive with no complications at 28 days, whereas three of the eight in the totally laparoscopic group showed evidence of temporary paraplegia. This experimental study demonstrates that a totally laparoscopic approach can be used to insert a bifurcated aortofemoral bypass with a proximal end-to-end anastomosis but currently does not save time and may increase the risk of neurologic complications.
Authors:
J Byrne; J W Hallett; C F Kollmorgen; M M Gayari; W Davies
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Annals of vascular surgery     Volume:  10     ISSN:  0890-5096     ISO Abbreviation:  Ann Vasc Surg     Publication Date:  1996 Mar 
Date Detail:
Created Date:  1996-10-10     Completed Date:  1996-10-10     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8703941     Medline TA:  Ann Vasc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  156-65     Citation Subset:  IM    
Affiliation:
Department of Biostatistics, Mayo Clinic, Rochester, Minn 55905, USA.
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MeSH Terms
Descriptor/Qualifier:
Anastomosis, Surgical / methods
Animals
Aorta / surgery*
Blood Loss, Surgical
Blood Vessel Prosthesis*
Carbon Dioxide / administration & dosage
Cardiopulmonary Bypass
Dogs
Feasibility Studies
Female
Femoral Artery / surgery*
Laparoscopy* / methods
Paraplegia / etiology
Pneumoperitoneum, Artificial
Polypropylenes
Postoperative Complications
Sutures
Swine
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Polypropylenes; 124-38-9/Carbon Dioxide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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