Aortobifemoral By-pass: Laparoscopy-Assisted and Totally Laparoscopic Operative Procedures

The use of minimally invasive laparoscopic techniques has expanded in recent years. As in other specialties, these techniques are becoming increasingly prevalent in vascular surgery. For aortic repair best results in terms of long-term patency are obtained by conventional sur- gery but its associated short-term morbidity and mortal- ity have not changed in the last 10 years. This situation created an opening for endovascular techniques that are much less invasive but with less reliable long-term results. In addition to endovascular surgery, video-endoscopic aortic surgery has been proposed as an alternative to con- ventional open surgery and is considered by some as a veritable third solution. The advantages of minimally in- vasive surgery are shorter intensive care and hospital stay, quicker resumption of intestinal transit, requirement for less analgesic and fewer abdominal wall complications. But specialized training is required to master the pro- cedure and to become acquainted with the coelioscopic practice necessary for laparoscopic suture.