ABSTRACT
Around two-thirds of all abdominal aortic aneurysms (AAA) are incidentally discovered. Open surgical repair of these aneurysms is considered the standard, traditional method of treatment. This report details the minimal invasive approach for a patient who presented with early gastric cancer and an AAA, and the patient underwent endovascular repair of the aneurysm prior to laparoscopic assisted distal gastrectomy. Esophagogastroduodenoscopy identified a malignant ulcer in the antrum and preoperative abdominal computer-tomography incidentally revealed a large AAA. The abdominal aortic aneurysm was the infra-renal type and the estimated size was 65 mm. Compared to open surgical intervention, the treatment of abdominal aortic aneurysm via endovascular aneurysm repair (EVAR) shortens the period of recovery. Also, intra-abdominal adhesion is avoided so that minimal invasive surgical intervention through the laparoscopic approach is possible for treating malignancy. EVAR is the recommended treatment for asymptomatic abdominal aortic aneurysm when this is associated with intra-abdominal malignancy.