Back to Annual Meeting Program

OBJECTIVES:
The feasibility of laparoscopic aortic surgery has been adequately demonstrated. Our clinical experience with robot-assisted aortoiliac reconstruction for occlusive diseases, aneurysms, endoleak II treatment and hybrid procedures performed using the da Vinci system is herein described.
METHODS:
Between November 2005 and April 2012, we performed 250 robot-assisted vascular procedures. 189 patients were prospectively evaluated for occlusive diseases, 48 patients for abdominal aortic aneurysm, two for common iliac artery aneurysm, two for splenic artery aneurysm, one for internal mammary artery aneurysm four for hybrid procedures, and four for endoleak II treatment post EVAR.
The robotic system was applied to construct vascular anastomosis, for thromboendarterectomy, for aorto-iliac reconstruction with closure patch, for dissection of the splenic artery, and for posterior peritoneal suture. A combination of conventional laparoscopic surgeries and robotic surgeries were routinely included. A modified, fully-robotic approach without laparoscopic surgery was used in the last 80 cases in our series.
RESULTS:
241 cases (96,4%) were successfully completed robotically, one patient's surgery was discontinued during laparoscopy due to heavy aortic calcification. In eight patients (3,2%) conversion was necessary. The thirty-day mortality rate was 0,4%, and non-lethal postoperative complications were observed in 13 patients (5,2%).
CONCLUSIONS:
Our experience with robot-assisted laparoscopic surgery has demonstrated the feasibility of this technique for occlusive diseases, aneurysms, endoleak II treatment post EVAR and hybrid procedures. The da Vinci robotic system facilitated the creation of the aortic anastomosis, and shortened the aortic clamping time as compared to purely laparoscopic techniques.