PURPOSE: Laparoscopic surgery decreases @entity282 , shortens hospital stay, and returns @entity1 to full functional status more quickly than open surgery for a variety of surgical procedures. This study was undertaken to evaluate laparoscopic techniques for application to @entity1028 ( @entity1028 ) repair. METHODS: Twenty @entity1 who had AAAs that required a tube graft underwent laparoscopically assisted @entity1028 repair. The procedure consisted of transperitoneal laparoscopic dissection of the @entity439 neck and iliac vessels. @entity1129 was then performed through a minilaparotomy using the port sites for the aortic and iliac clamps. Data included operative times, duration of nasogastric suction, intensive care unit days, and postoperative hospital days. Pulmonary artery catheters and transesophageal echocardiography were used in seven @entity1 . For these @entity1 data included heart rate, @entity551 , mean arterial pressure, central venous pressure, pulmonary capillary wedge pressure, cardiac index, and end diastolic area. Data were obtained before induction, during and after insufflation, during aortic cross-clamp, and at the end of the procedure. RESULTS: Laparoscopically assisted @entity1028 repair was completed in 18 of 20 @entity1 . Laparoscopic and total operative times were 1.44 +/- 0.44 and 4.1 +/- 0.92 hours, respectively. Duration of nasogastric suction was 1.3 +/- 0.7 days. Intensive care unit stay was 2.2 +/- 0.9 days. The mean length of hospital stay was 5.8 days excluding three @entity1 who underwent other procedures. There were two minor complications, one major complication (colectomy after @entity63 ), and no deaths. For the eight @entity1 who had intraoperative transesophageal echocardiographic monitoring, no changes were noted in heart rate, pulmonary artery systolic pressure, pulmonary capillary wedge pressure, and cardiac index. Pulmonary artery diastolic pressure and central venous pressure were greatest during insufflation without changes in end-diastolic area. Volume status, as reflected by end-diastolic area and pulmonary capillary wedge pressure, did not change. CONCLUSIONS: Laparoscopically assisted @entity1028 repair is technically challenging but feasible. Potential advantages may be early removal of nasogastric suction, shorter intensive care unit and hospital stays, and prompt return to full functional status. The hemodynamic data obtained from the pulmonary artery catheter and transesophageal echocardiogram during @entity516 suggest that transesophageal echocardiography may be sufficient for evaluation of volume status along with the added benefit of detection of regional wall motion abnormalities and @entity337 . Further refinement in technique and instrumentation will make total laparoscopic @entity1028 repair a reality.

Laparoscopically assisted XXXX repair: first 20 cases.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity63 :: ('MESH:D007511', 'Disease') :: ['colon ischemia'] @entity551 :: ('MESH:D007022', 'Disease') :: ['pulmonary artery systolic and diastolic pressures'] @entity439 :: ('MESH:D000783', 'Disease') :: ['aneurysm'] @entity337 :: ('MESH:D001022', 'Disease') :: ['aortic insufficiency'] @entity1129 :: ('MESH:D001260', 'Disease') :: ['A standard endoaneurysmorrhaphy'] @entity516 :: ('MESH:D011027', 'Disease') :: ['pneumoperitoneum'] @entity282 :: ('MESH:D010149', 'Disease') :: ['postoperative pain'] @entity1028 :: ('MESH:D017544', 'Disease') :: ['abdominal aortic aneurysm', 'AAA']
@entity1028 :: (MESH:D017544,Disease) :: ['abdominal aortic aneurysm']
