Dion Y M, Katkhouda N, Rouleau C, Aucoin A
Department of Surgery, St-François d'Assise Hospital, Québec City, Canada.
Surg Laparosc Endosc. 1993 Oct;3(5):425-9.
Therapeutic laparoscopy has substantially simplified the postoperative course of patients suffering from hepatobiliary, gastric, or colonic disease. One important advantage of this modality is the decrease in postoperative pain, which diminishes the potential for cardiopulmonary problems. Patients with aortoiliac atherosclerotic disease are at high risk for postoperative complications, and a minimally invasive procedure may favorably affect their postoperative recovery. We describe here the first patient on whom we performed a laparoscopy-assisted aortobifemoral bypass. Under the pneumoperitoneum, seven 10-mm trocars were inserted to permit aortic dissection and creation of retroperitoneal tunnels to the femoral regions. After evacuation of the pneumoperitoneum, an 8-cm midline incision was made to allow a side-to-end aortic anastomosis. The patient's postoperative period was uncomplicated by any cardiopulmonary problems despite his history of three myocardial infarctions; the patient had minimal pain that allowed for a quick return to ambulation. This procedure is minimally invasive and appeared to simplify the postoperative period in our patient. It could become the procedure of choice for certain patients with aortoiliac disease.
治疗性腹腔镜检查已极大地简化了患有肝胆、胃或结肠疾病患者的术后病程。这种治疗方式的一个重要优势是术后疼痛减轻，这降低了出现心肺问题的可能性。患有主髂动脉粥样硬化疾病的患者术后并发症风险很高，而微创手术可能会对他们的术后恢复产生有利影响。我们在此描述了首例接受腹腔镜辅助主双股动脉搭桥术的患者。在气腹状态下，插入7个10毫米的套管针，以进行主动脉剥离并创建通向股部的腹膜后隧道。气腹排空后，做一个8厘米的中线切口，以便进行端侧主动脉吻合。尽管该患者有三次心肌梗死病史，但其术后病程未出现任何心肺问题；患者疼痛轻微，能够很快恢复行走。该手术具有微创性，且似乎简化了我们这位患者的术后病程。它可能会成为某些主髂动脉疾病患者的首选手术方式。
