Minimal incision abdominal aortic aneurysm repair

Purpose: The use of a limited incision for abdominal aortic aneurysm (AAA) repair was evaluated, and its outcome was analyzed in comparison to laparos copic-assisted and standard open repair. Methods: Eleven patients who had an AAA that required a tube graft underwen t minimal incision (MINI) repair. The procedure consisted of a standard end oaneurysmorrhaphy performed through an 8- to 10-cm minilaparotomy. Clinical characteristics, in-hospital outcomes, and total in-hospital charges for t his procedure were then compared with those of comparative groups of patien ts who had undergone repair of AAA by means of a laparoscopic-assisted (LAP ) approach or a standard open (OPEN) technique. Results: MINI repair was successfully completed in all 11 patients. Patient s in the three groups were comparable for age, sex, risk factors, and aorti c dimensions. The mean values for operative time, blood loss, length of hos pital stay, and total hospital charges for the three comparison groups were : 129.7 minutes (MINI) vs. 244.8 minutes (LAP)*, 209.9 minutes (OPEN)*; 522 .7 mL (MINI) vs. 1214.7 mt (LAP), 1795.8 mt (OPEN)*; 5.18 days (MINI) vs. 1 8.7 days (LAP), 17.4 days (OPEN); $22,692 (MINI) vs. $59,922 (LAP)*, $62,32 4 (OPEN)* (*P <.05). Local complications occurred in 18.2% of patients who underwent MINI repair, 23.5% of patients who underwent LAP repair, and 29.7 % of patients who underwent OPEN repair (P = not significant). Patients und ergoing minilaparotomy demonstrated decreased compromise of gastrointestina l function, with a decreased need for postoperative fluid resuscitation (67 99.7 mt [MINI], 7781.8 mt [LAP] vs. 11061.1 mL [OPEN]*) and shortened nasog astric tube decompression (1.6 days [MINI], 1.5 days [LAP] vs. 4.1 days [OP EN]*; *P<.05). Conclusion: MINI repair is a technically feasible technique that combines t he benefits of minimally invasive surgery with those of conventional open r epair with few, if any disadvantages. Facility of the procedure, combined w ith the potential cost benefits, encourages further study for consideration of this technique as a viable alternative for the management of AAAs.