J Korean Surg Soc.  2009 Apr;76(4):266-269. 10.4174/jkss.2009.76.4.266.

Robot Assisted Aorto-femoral Bypass

• Eom BW
• Lee T
• Kim HH
• Han HS
• Ha J
• Chung JK
• Kim SJ

• KMID: 1465067
• DOI: http://doi.org/10.4174/jkss.2009.76.4.266

Abstract

Laparoscopic vascular surgery has not been widely embraced by vascular surgeons because of the specific technical skills needed in performing vascular anastomosis. Robot assisted vascular surgery has shown the possibility to overcome several limitations of laparoscopic vascular surgery in previous studies. We report two cases of robot assisted aortofemoral bypass grafting for aortoiliac occlusive disease. Two male patients, 65 and 62 years old were admitted complaining of disabling claudication. CT angiography revealed total occlusion of left iliac artery and bilateral superficial femoral arteries in one case and concentric stenosis of lower abdominal aorta, severe occlusion of left common iliac artery in the other case. Laparoscopic aortofemoral bypass grafting was performed with a proximal end-to-side anastomosis constructed with robotic arms using Dacron graft. Femoral anastomosis was performed in the conventional method. The aortic clamping times were 80 and 198 minutes and operating times were 435 and 605 minutes, respectively. The patients were discharged uneventfully on postoperative days 20 and 13. Robot assisted vascular surgery is a technically feasible and safe procedure.

Keyword

Robot assisted aortofemoral bypass; Aortoiliac occlusive disease

MeSH Terms

Angiography
Aorta, Abdominal
Arm
Constriction
Constriction, Pathologic
Femoral Artery
Humans
Iliac Artery
Male
Polyethylene Terephthalates
Transplants
Polyethylene Terephthalates

Figure

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  Fig. 1 (A) Preoperative CT angiography shows total occlusion of left iliac artery and bilateral superficial femoral arteries. (B) Intraoperative laparoscopic view; Y type Dacron vascular prosthesis was located and retroperitoneal tissue was fixed to abdominal wall. (C) Operative view; Five trocar ports were inserted and three robot arms were applied. Bilateral iliac limbs of graft were placed at bilateral groins. (D) Postoperative CT angiogram shows good patency of bilateral iliac grafts. (E) Postoperative picture shows small sized abdominal wounds.

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  Fig. 2 Preoperative CT angiography shows concentric stenosis of lower abdominal aorta, occlusion of left common iliac artery and external iliac artery.

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