Laparoscopic surgery for aneurysm of the abdominal aorta

Introduction. Surgical mortality from aneurysms of the abdominal aorta (AAA) is less than 3%, but surgical morbidity is still significant and very often secondary to the problems deriving from the large incisions that are made. The post-operative period rarely lasts less than a week and a certain degree of morbidity (hypothermia, pain, atelectasis, prolonged ileus, wall seroma, etc.) occurs in over half the operated patients. The endovascular alternative is far from being the decisive one until the perfect endoprosthesis appears, but the appearance of 'minimally invasive video-assisted surgery', which combines laparoscopy and conventional surgery (minilaparotomy), seems to have brought about a significant reduction in this morbidity. Aims. To demonstrate that laparoscopic surgery of the abdominal aorta is a feasible, safe alternative that minimises hospital morbidity and shortens the stay in hospital. Case report. A 73-year-old patient was recommended for surgery following the growth of his aneurysm of the aorta. Laparoscopic techniques were used, with the creation of pneumoperitoneum and the introduction of trocars, and then the aneurysm was dissected with the abdomen closed. Finally, the prosthesis was introduced by means of a minilaparotomy. The anaesthetic technique employed was the same as usual. Results. The patient required a minimum amount of analgesics, diet was started after 24 h, he began walking after 48 h and was discharged on the fourth day, totally asymptomatic. Conclusions. Minimally invasive video-assisted surgery of the aorta appears as a valid alternative in the treatment of AAA.