The role of laparoscopy in vascular surgery : our experience

Abstract

Even though the history of vascular surgery originates from 1900, laparoscopy assisted vascular procedures were only reported in 1993. Since then this minimally invasive approach has gained popularity for both occlusive and aneurysmal conditions with the advantages of less postoperative pain, early ambulation and reduced hospital stay. External iliac artery occlusion may be treated with angioplasty and stenting or by open bypass. Open bypass from the aorta or the common iliac artery to the femoral artery requires a substantial incision. Laparoscopic dissection allows exposure of the vessels with small port site incisions. The anastomosis may be done using intracorporeal suturing or a mini incision (1,2,3). We present a 44-year-old male who underwent a laparoscopy assisted ilio-femoral bypass. Case report A 44-year-old male smoker presented with rest pain and gangrene of the left 4th and 5th toes. He gave a history of intermittent claudication of ipsilateral thigh and calf. He had no history of ischaemic heart disease, cerebral ischaemia or mesenteric angina. On examination he had a weak left femoral pulse and an iliac bruit. His popliteal, posterior tibial and dorsalis pedis pulses were absent. His ankle-brachial pressure index (ABPI) was 0.3. Digital subtraction angiography (DSA) showed a narrowing of the left external iliac artery and occlusion of the left superficial femoral artery. There were multiple collaterals reforming the popliteal artery (Figure 1).