ABSTRACT
No disponible
Subject(s)
Humans , Female , Middle Aged , Ischemia/complications , Ischemia/diagnosis , Myxoma/physiopathology , Myxoma , Ischemia , Upper Extremity/pathology , Upper Extremity , Echocardiography/methods , EchocardiographySubject(s)
Humans , Male , Aged , Laparoscopy , Aortic Aneurysm, Abdominal/surgery , Vascular Surgical Procedures/methodsSubject(s)
Aortic Aneurysm, Abdominal/surgery , Laparoscopy , Aged , Humans , Male , Vascular Surgical Procedures/methodsABSTRACT
The aim of laparoscopic vascular surgery in the aortoiliac segment is to replicate the excellent outcomes of open aortic surgery while providing the advantages of minimally invasive surgery. We report the case of a 49-year old man with disabling hip claudication and rest pain in his left lower extremity. On examination the patient had reduced right femoral pulse and absent pulses in his left lower extremity. Angiography revealed occlusive disease in the left aortoiliac segment and right common iliac artery stenoses. Laparoscopic aortobifemoral bypass was planned. The surgical technique included 70 degrees -right lateral decubitus position and retrorenal retrocolic dissection from the left common iliac artery to the left renal vein. Minilaparotomy consisted of aortic clamping, arteriotomy, and end-to-side aorto-prosthetic anastomosis with Dacron graft. Time to extubation was 5 hours; peristalsis was recovered 72 hours after surgery. The patient was discharged from hospital after cardiologic assessment 9 days after surgery.
Subject(s)
Aorta, Abdominal/surgery , Arterial Occlusive Diseases/surgery , Blood Vessel Prosthesis Implantation , Femoral Artery/surgery , Iliac Artery , Laparoscopy , Leg/blood supply , Angiography , Arterial Occlusive Diseases/diagnostic imaging , Humans , Laparotomy , Male , Middle Aged , Minimally Invasive Surgical Procedures , Radiography, Abdominal , Tomography, X-Ray ComputedABSTRACT
El objetivo de la cirugía vascular laparoscópica en el sector aortoilíaco es reproducir los excelentes resultados de la cirugía clásica minimizando la agresión quirúrgica. Presentamos el caso clínico de un varón de 49 años con claudicación invalidante en las caderas y dolor de reposo en el miembro inferior izquierdo (MII). A la exploración, el pulso femoral derecho era débil y había ausencia de pulsos en el MII. La aortoarteriografía demostró una oclusión ilíaca izquierda y un eje ilíaco derecho filiforme. Se consideró la opción quirúrgica de bypass aortobifemoral laparoscópico. La intervención quirúrgica se llevó a cabo con el paciente en decúbito lateral derecho de 70°; se realizó una disección aórtica retrocólica retrorrenal, desde origen de la arteria ilíaca primitiva izquierda hasta vena renal izquierda; la minilaparotomía consistió en pinzamiento aórtico, aortotomía y anastomosis aortoprotésica en terminolateral con dacron. Se extubó al paciente a las 5 h, que presentó peristalsis a las 72 h. Se le dio el alta ambulatoria tras revisión cardiología programada, al noveno día de la intervención (AU)
The aim of laparoscopic vascular surgery in the aortoiliac segment is to replicate the excellent outcomes of open aortic surgery while providing the advantages of minimally invasive surgery. We report the case of a 49-year old man with disabling hip claudication and rest pain in his left lower extremity. On examination the patient had reduced right femoral pulse and absent pulses in his left lower extremity. Angiography revealed occlusive disease in the left aortoiliac segment and right common iliac artery stenoses. Laparoscopic aortobifemoral bypass was planned. The surgical technique included 70°-right lateral decubitus position and retrorenal retrocolic dissection from the left common iliac artery to the left renal vein. Minilaparotomy consisted of aortic clamping, arteriotomy, and end-to-side aorto-prosthetic anastomosis with Dacron graft. Time to extubation was 5 hours; peristalsis was recovered 72 hours after surgery. The patient was discharged from hospital after cardiologic assessment 9 days after surgery (AU)
