Videoendoscopic vascular surgery on aortoiliac vessels

Abstract

Background: In order to avoid the postoperative complications following conventional surgical treatment of aortoiliac atherosclerotic occlusive disease, a new concept in videoendoscopic vascular surgery on the infrarenal aortoiliacal artery was created.

Methods: New instruments for endoscopic vascular surgery were therefore developed. Having elaborated the practicability of “videoendoscopic surgery” in four short-term pilot studies in piglets, we performed a standardized acute study in healthy male piglets (32 ± 2 kg). Blood flow was monitored ultrasonically in the femoral arteries and systemic and hemodynamic parameters were evaluated in all animals.

Results: The investigation regarding ultrasonically monitored blood flow in the femoral arteries (four aortofemoral bypasses, four iliac patchplasties) and other systemic, hemodynamic parameters after videoendoscopic vascular reconstruction revealed positive results. The following series of standardized long-term animal experiments revealed that 2–7 weeks after the aortofemoral bypass grafting (n= 5), the animals were all doing well. The angiographic examination showed that the prostheses were patent.

Conclusions: Even though it was possible to carry out the endoscopic vascular method according to the rules of conventional vascular surgery, further experimental research and development of endoscopic instruments have yet to be done in order to optimize the new surgical method. This is the subject of our ongoing long-term animal studies.