Minilaparotomy for Aortoiliac Occlusive Disease: Preliminary Results

This prospective study was designed to establish the feasibility of minilaparotomy for aortobifemoral bypass, and its effect on intraoperative and postoperative variables. A minilaparotomy has potential benefits for the patient, including smaller size of the surgical wound, reduced riskof infection, shorter postoperative intubation, decreased postoperative pain, earlier discharge, and a smaller, aesthetically more acceptable postoperative scar. Moreover, reoperation is less hazardous, because the peritoneumis not completely dissected. From the beginning of June 1999 through the end of September 2001, we used a minilaparotomy in 33 patients with aortoiliac occlusive disease. Obesity and prior abdominal surgerywere regarded as contraindications to the operation. One patient required conversion to a full laparotomybecause of intraoperative bleeding. Another patient developed wound infection. There were no deaths. The technique has proved safe, effective, and aesthetically acceptable to the patient. To date, no study has compared a median laparotomywith a minimally invasive alternative for the surgical treatment of aortoiliac occlusive disease. Prospective randomized trials are needed to determine whether minilaparotomy is the superior technique for treatment of aorto-occlusive disease. (Tex Heart Inst J 2002;29:316–8)