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.
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References
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.
Rob C. Extraperitoneal approach to the abdominal aorta. Surgery 1963; 53: 87–9.
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.
Further reading
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.
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.
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.
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.
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© 1994 Springer Science+Business Media Dordrecht
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Leather, R.P., Chang, B.B., Darling, R.C., Shah, D.M. (1994). Retroperitoneal approach to aortic aneurysms. In: Jamieson, C.W., Yao, J.S.T. (eds) Vascular Surgery. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-6854-8_21
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DOI: https://doi.org/10.1007/978-1-4899-6854-8_21
Publisher Name: Springer, Boston, MA
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