Minilaparotomy for Abdominal Aortic Aneurysm Repair

A median laparotomy is the standard approach for endoaneurysmorrhaphy of abdominal aortic aneurysms. The so-called minilaparotomy, which has come into use in recent years to reduce surgical trauma, provides good exposure of the operating field, similar to that afforded by the conventional procedure. From the beginning of June 1999 through the end of October 2000, we used a minilaparotomy for abdominal aortic endoaneurysmorrhaphy in 26 patients. Endoaneurysmorrhaphy was performed without difficulty through an 8- to 10-cm paraumbilical transperitoneal incision. Aneurysms greater than 10 cm in diameter, prior abdominal surgery, and obesity were considered contraindications to the operation. Two of the 26 patients required conversion to full laparotomy because of intraoperative bleeding. There was 1 wound infection and no fatality. The technique proved to be safe, effective, and aesthetically acceptable to the patient. The laparoscopic approach to vascular surgery is still in its experimental phase. Although the minilaparotomy appears to be of great potential benefit, further study is needed to compare its postoperative results with those of standard median laparotomy.