Retroperitoneal approach to aortic aneurysms

  • Robert P. Leather
  • Benjamin B. Chang
  • R. Clement Darling
  • Dhiraj M. Shah

Abstract

Many surgeons prefer the retroperitoneal approach to repair of aortic aneurysms only in ‘high-risk’ patients but the authors apply this approach to all patients in an effort to minimize operative trauma and shorten hospital stay. The approach used at this centre is usually the ‘extended’ retroperitoneal approach first reported by Williams et al.1 because this posterolateral exposure of the aorta affords the widest and most flexible exposure. Use of a more anterior retroperitoneal exposure (as originally reported by Rob2 and more recently advocated by others) limits aortic exposure and in many instances is more technically difficult to perform. However, it is very similar anatomically to that gained by transperitoneal techniques and many surgeons feel more comfortable with the anterior approach, rather than the relatively unfamiliar posterolateral approach.

Keywords

Catheter Ischemia Heparin Polypropylene Mannitol 

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References

  1. 1.
    Williams GM, Ricotta J, Zinner M, Burdick J. The extended retroperitoneal approach for treatment of extensive atherosclerosis of the aorta and renal vessels. Surgery 1980; 88: 846–55.PubMedGoogle Scholar
  2. 2.
    Rob C. Extraperitoneal approach to the abdominal aorta. Surgery 1963; 53: 87–9.PubMedGoogle Scholar
  3. 3.
    Stoney RJ, Reilly LM, Ehrenfeld WK. Chronic mesenteric ischemia and surgery for chronic visceral ischemia. In: Wilson SE, Veith FJ, Hobson RW III, Williams RA, eds. Vascular Surgery. Principles and Practice. New York: McGraw-Hill, 1987; 672–84.Google Scholar

Further reading

  1. Chang BB, Paty PSI, Shah DM, Leather RP, Kaufman JL. The right retroperitoneal approach for abdominal aortic surgery. Am J Surg 1989; 158: 156–8.PubMedCrossRefGoogle Scholar
  2. Chang BB, Shah DM, Paty PSK, Kaufman JL, Leather RP. Can the retroperitoneal approach be used for ruptured abdominal aortic aneurysms? J Vasc Surg 1990; 11: 326–30.PubMedGoogle Scholar
  3. Leather RP, Darling RC III, Chang BB, Shah DM. Retroperitoneal in-line aortic bypass for treatment of infected infrarenal aortic grafts. Surg Gynecol Obstet 1992; 175: 491–4.PubMedGoogle Scholar
  4. Leather RP, Shah DM, Kaufman JL, Fitzgerald KM, Chang BB, Feustel PJ. Comparative analysis of retroperitoneal and transperitoneal aortic replacement for aneurysm. Surg Gynecol Obstet 1989; 168: 387–93.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 1994

Authors and Affiliations

  • Robert P. Leather
    • 1
  • Benjamin B. Chang
    • 1
  • R. Clement Darling
    • 1
  • Dhiraj M. Shah
    • 1
  1. 1.Vascular Surgery Section A61Albany Medical CollegeAlbanyUSA

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