The aim was to perform a totally laparoscopic thrombendarterectomy (TEA) of
the infrarenal aorta to reduce the trauma connected to the surgical approa
ch. A 52-year-old man was referred to our institution with severe claudicat
ion. Angiography revealed a subtotal stenosis of the infrarenal aorta. Beca
use the lesion was not suitable for an interventional procedure, a TEA was
planned. The surgery was performed through Six ports using a transperitonea
l approach with pneumoperitoneum. The laparoscopic TEA was carried out acco
rding to the standards of open vascular surgery. The surgery time was 285 m
inutes, the;crossclamping lasted 105 minutes, and the blood loss was 100 mL
. The angiographic and functional results were excellent. The patient exper
ienced a rapid recovery and was discharged after 6 days. This case report s
hows the feasibility of totally laparoscopic TEA of the infrarenal aorta. T
he well-known advantages of minimally invasive techniques in abdominal surg
ery with regard to the decrease of surgical trauma may also be valid in aor
tic surgery for occlusive disease.