POSTEROLATERAL RETROPERITONEAL APPROACH A ND EXCLUSION TECHNIQUE IN THE TREATMENT OF INFRARENAL AORTIC-ANEURYSM - FIRST EXPERIENCES

Although the infrarenal aorta is a retroperitoneal structure, the surg ical access has been tl transperitoneal especially when dealing with i nfrarenal aneurysms. After the opening of the sack a tube-or bifurcate d graft is implanted. with the posterolateral retroperitoneal (RP) app roach described by G. M. Williams in 1980 access to the aorta can be g ained without opening the peritoneal cavity. With the non resective ex clusion technique the intraoperative blood loss is minimized. This met hod is routinely used in Albany N.Y. for the treatment of infrarenal a neurysms. We describe here our first experiences with 44 RP excluded a ortic aneurysms. Despite the small number of cases we can confirm the advantages described in the larger series of Sicard ct al. and Leather and Shah: the RP approach and the exclusion technique can be routinel y used for infrarenal aneurysms. It is associated with a smoother and shorter posteroperative period (8 to 10 days).