Minilaparotomy in aortic surgery

Aims. To evaluate the clinical impact of using minilaparotomy in aortic surgery. Patients and methods. Between August 2001 and January 2002 prospective surgery was carried out on 15 patients with an average age of 66.6 (53-76), who were suffering from abdominal aorta aneurysm (14) and Leriche's syndrome (1). The operation was performed using an aortic approach by means of a minilaparotomy with a mean length of 10.5 cm (8-12). Automatic separators (omnitrac) were used, and no evisceration was performed; iliac clamping was percutaneous. In all 1 branched and 14 straight prostheses were implanted. Peroperative (clamping time, blood loss, patient's temperature, depth of anaesthesia, total surgery time) and post-operative parameters (extubation time, onset of peristaltism, analgesia consumption and number of days' hospitalization) were analysed. Results. Morbiditymortality was null, the average clamping time was 42 minutes, average losses were 350 cm3 and the patient's final temperature was never below 36 °C. The average total intervention time was 129 minutes. Extubation was carried out in all patients before 2 hours and all of them began oral feeding before 48 hours. No drugs containing morphine or its derivatives were needed and they were discharged from hospital after an average of 4.2 days (3-5). Conclusions. While still waiting for a permanent endoprosthesis, an aortic approach using minilaparotomy is a safe and comfortable technique for the patient and may be the first choice technique given its low cost as compared with the alternatives.