Mid-term results of robot-assisted laparoscopic surgery for aortoiliac occlusive disease

Abstract

The aim of this study was to evaluate middle-term clinical results of robot-assisted laparoscopic surgery (RALS) to treat aortoiliac occlusive disease (AIOD). Between 2002 and 2007, 28 consecutive patients received robot-assisted laparoscopic aortobifemoral bypass grafting (n = 24) or aortoiliac endarterectomy (n = 4). Patients were followed prospectively. RALS could be completed successfully in 24 patients; conversion to open surgery was necessary in four patients (14%). Median operative time was 350 min. Median aortic clamping time was 70 min. Median hospital stay was five days. One patient died within 30 days. Non-lethal complications occurred in four patients (14%). Clinical symptoms improved in all patients. Primary and secondary limb-based patencies at 36 months were 89% and 91%, respectively. In conclusion, RALS is a feasible and durable technique for patients with AIOD. Although operative times are long, RALS allows rapid postoperative recovery.

Totally laparoscopic aortobifemoral bypass surgery in the treatment of aortoiliac occlusive disease or abdominal aortic aneurysms – a systematic review and critical appraisal of literature

“…Three studies reported slightly higher rates of 32%,62 33%65 and 23.8% 68. Length of hospital stay was reported by eight studies59,61,64–68,71 and ranged from 564 to 10.161 days. In terms of patency, the different studies demonstrated large variation in follow-up times.…”

“…Finally, 16 studies were deemed eligible for inclusion in the quantitative synthesis, two of them concerning robotic surgery58,59 and one AAA surgery 60…”

“…The sample size ranged from 1161 to 139 patients62 in the intervention group, the equivalent numbers for the open control group were 145 to 1564 patients. Most patients were classified as C or D according to the Trans-Atlantic Inter-Society Consensus (TASC) classification,63 with two publications also including TASC B lesions 59,64. Seven articles did not report the TASC classification of the included patients 61,65–70…”

“…Overall, the operating time ranged from 24068 to 376 minutes65 in the 10 cohorts concerning AIOD,58,59,61,62,64–68,71 with aortic cross-clamping time ranging from 5971 to 121 minutes (Table 2). 65 The perioperative blood loss ranged from 49764 to 115059 mL.…”

“…65 The perioperative blood loss ranged from 49764 to 115059 mL. Between 5%64 and 27%61 of the procedures resulted in conversion to open surgery or HALS.…”