Total laparoscopic bypass for aortoiliac occlusive lesions: 93-case experience

Coggia, Marc; Javerliat, Isabelle; Centa, Isabelle Di; Colacchio, Giovanni; Leschi, J; Kitzis, M; Goëau-Brissonnière, Olivier

doi:10.1016/j.jvs.2004.08.013

Cited by 86 publications

(52 citation statements)

References 18 publications

(15 reference statements)

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“…Compared to various larger series [4,7,9,12,14,15], the aortic anastomosis time and the aortic clamp time in this series became acceptable after the first 8 patients. In our institution patients are treated by endovascular techniques for aortoiliac occlusive disease, and only a few patients need surgery.…”

Section: Discussionmentioning

confidence: 58%

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Robot-assisted laparoscopic surgery of the infrarenal aorta

et al. 2007

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Background: Recently introduced robot-assisted laparoscopic surgery (RALS) facilitates endoscopic surgical manipulation and thereby reduces the learning curve for (advanced) laparoscopic surgery. We present our learning curve with RALS for aortobifemoral bypass grafting as a treatment for aortoiliac occlusive disease. Methods: Between February 2002 and May 2005, 17 patients were treated in our institution with robot-assisted laparoscopic aorto-bifemoral bypasses. Dissection was performed laparoscopically and the robot was used to make the aortic anastomosis. Operative time, clamping time, and anastomosis time, as well as blood loss and hospital stay, were used as parameters to evaluate the results and to compare the first eight (group 1) and the last nine patients (group2). Results: Total median operative, clamping, and anastomosis times were 365 min (range: 225-589 min), 86 min (range: 25-205 min), and 41 min (range: 22-110 min), respectively. Total median blood loss was 1,000 ml (range: 100-5,800 ml). Median hospital stay was 4 days (range: 3-57 days). In this series 16/18 anastomoses were completed with the use of the robotic system. Three patients were converted (two in group 1, one in group 2), and one patient died postoperatively (group 1). Median clamping and anastomosis times were significantly different between groups 1 and 2 (111 min Conclusions: Robot-assisted aortic anastomosis was shown to have a steep learning curve with considerable reduction of clamping and anastomosis times. However, due to a longer learning curve for laparoscopic dissection of the abdominal aorta, operation times were not significantly shortened. Even with robotic assistance, laparoscopic aortoiliac surgery remains a complex procedure.

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Section: Discussionmentioning

confidence: 58%

“…Laparoscopic creation of an aortic anastomosis however, is indisputably challenging and requires a great deal of practice and experience before it can be applied in everyday clinical practice [7,12].…”

Section: Discussionmentioning

confidence: 99%

Robot-assisted laparoscopic surgery of the infrarenal aorta

et al. 2007

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“…Where RALS has been used in various fields of surgery, such as cardiac-, general-, gynecologic-, thoracic-, and urologic surgery, vascular surgery remains an area in which robotic surgery has yet to establish its current role. Reported series show that RALS is a feasible and safe procedure, with operative-and clamping times which are comparable to larger series of totally laparoscopic aortoiliac surgery (Coggia et al, 2004;Dion et al, 2004;Olinde et al, 2005). Conversion rate was less when compared to some smaller series in laparoscopic vascular surgery (Barbera et al, 1998;Rouers et al, 2005;Dooner et al, 2006).…”

Section: Discussionmentioning

confidence: 90%

“…These aspects seem helpful when performing complex endoscopic procedures such as suturing a vascular anastomosis. Furthermore, RALS has shown to overcome a long learning curve which is associated with laparoscopic vascular surgery (Coggia et al, 2004). Even with few numbers of patients, clamping -and anastomosis time reduced significantly after only eight patients (Diks et al, 2007).…”

Section: Discussionmentioning

confidence: 99%

“…Creation of the anastomosis requires a lot of skill, exercise and dexterity. Various authors reported to have been practicing for several months before gaining sufficient proficiency to implement vascular laparoscopy into everyday practice (Coggia et al, 2004;Olinde et al, 2005). Robotic surgical systems have been developed to facilitate advanced laparoscopic procedures particularly suturing anastomosis as in aortoiliac laparoscopic surgery (Wisselink et al, 2002;Killewich et al, 2004;Desgranges et al, 2004;Kolvenbach et al, 2004;Ruurda et al, 2004;Nio et al, 2004;Nio et al, 2005a;Nio et al, 2005b;Stadler et al, 2006;Ishikawa et al, 2006;Mehrabi et al, 2006;Diks et al, 2007;Diks et al, submitted).…”

Section: Introductionmentioning

confidence: 99%

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Robot Assisted Laparoscopic Surgery for Aortoiliac Disease: A Systematic Review

Diks¹,

Nio²,

Wisselink³

et al. 2008

Medical Robotics

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Robotic systems have been used to overcome the technical difficulties in laparoscopic aortoiliac surgery. In this chapter the outcomes of clinical and experimental studies using a robotic surgical system for treatment of aortoiliac disease are reviewed. MethodsA computerized search was conducted in the medical databases Medline (from January 2000 to July 2007), Embase (from January 2000 to July 2007) and the Cochrane Database of Systematic Reviews. Operative times, ICU-stay, clamping time, blood loss, anastomosis time, time to resume to solids, hospital stay, mortality and conversion rates were described. Experimental studies reporting on the creation of an aortic anastomosis with the robotic system were included. ResultsExperimental studies on vascular anastomoses showed equal results when compared to laparoscopy using the Zeus system, whereas the da Vinci robot showed better anastomosistimes and more precise anastomoses when compared to laparoscopic surgery. Five clinical studies were identified, with in total 70 patients. Operative time varied from 188 to 480 minutes, anastomosis time was 27 to 40.8 minutes. Total hospital stay differed between 4 and 7.3 days. An overall conversion rate of 7 (10%) was reported.

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Surgical Treatment of Iliac and Lower Extremity Artery Disease

Vermassen

2010

Cardiovascular Interventions in Clinical Practice

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Total laparoscopic bypass for aortoiliac occlusive lesions: 93-case experience

Abstract: Total laparoscopic aortic bypass is feasible. In patients with TASC C and D aortoiliac occlusive lesions, short-term outcomes are comparable to those with conventional aortic bypass. After the initial learning curve, laparoscopic technique may reduce the operative trauma of aortic bypass.

Cited by 86 publications

References 18 publications

Robot-assisted laparoscopic surgery of the infrarenal aorta

Robot-assisted laparoscopic surgery of the infrarenal aorta

Robot Assisted Laparoscopic Surgery for Aortoiliac Disease: A Systematic Review

Surgical Treatment of Iliac and Lower Extremity Artery Disease

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