Chapter 62 - Laparoscopic and robotic aortic surgery

Question 1

Approaches to total laparoscopic aortic bypass

Answer 1

1) Retrocolic prerenal transperitoneal approach
2) retrocolic retrorenal transperitoneal approach
3) combined transperitoneal and retroperitoneal approach
4) retroperitoneal approach

Question 2

Hand-assisted laparoscopic surgery

Answer 2

Enables one hand into abdomen via a 7-8 cm port-site device

Question 3

Total robotic vs robot assisted

Answer 3

Robot assisted is only used for suturing

Question 4

Laparoscopic and robot aortic

operative time

Answer 4

Robot 199-391

Hand-assisted laparoscopic fastest 149-350 min

Question 5

Mortality

Answer 5

1.8%

higher in total laparoscopic surgery

Question 6

Conversion to open surgery

Answer 6

2.6 - 9.1%

higher for total laparoscopic and lowest for hand-assisted

Question 7

Reason to convert to open

Answer 7

1) calcified aorta
2) bleeding
3) self-imposed operative time/clamp time limits