VIDEOASSISTED MINIMALLY INVASIVE EXPOSURE OF THE ABDOMINAL-AORTA THROUGH RETROPERITONEAL APPROACH FOR AORTOILIAC RECONSTRUCTIVE SURGERY

The morbidity and mortality rate of aortoiliac reconstruction is signi ficant even in patients who are at low risk undergoing aortic surgery. Beyond the general extent of vascular disease, the great surgical int ervention using a large vertical midline or transverse abdominal incis ion is also responsible for this events. To decrease the surgical stre ss a new minimal retroperitoneal approach was developed. To exposure t he infrarenal aortic segment a 7 cm left paramedian incision is used, a special retractor and modified surgical instruments combining direct visualization of the operation field with flexible videoendoscopic co ntrol. This new approach offers the possibility to decrease the operat ive stress and enables complete control if serious bleeding might occu r. This 'minimally invasive' approach appears to diminish the cataboli c response and is hopefully associated with accelerated recovery and v irtual abolition of large wound-related complications.