Total robotic ligation of inferior mesenteric artery for type II endoleak after endovascular aneurysm repair

Annals of Vascular Surgery
Judith C LinDaniel J Reddy

Abstract

We present a case of totally robotic ligation of the inferior mesenteric artery (IMA) for treatment of a persistent endoleak from the IMA into the aneurysm sac after endovascular aneurysm repair (EVAR). An 84-year-old male underwent EVAR with a Gore Excluder stent graft for an asymptomatic infrarenal abdominal aortic aneurysm. Follow-up computed tomographic (CT) scan showed persistent type II endoleak from the IMA, with progressive enlargement of the aneurysm sac from 5 to 6.1 cm over an 18-month period. In this case, the patient underwent ligation of the IMA using the da Vinci Surgical System for the treatment of retrograde flow into the aneurysm sac. The total operating time was 249 min; of this, the robotic assistance time was approximately 180 min. No intraoperative complications occurred. The estimated blood loss was 50 mL and the urine output 650 mL. The patient was extubated immediately after the procedure and tolerated a regular diet the following day. He was discharged home with a urinary catheter on postoperative day 2. CT scan postoperatively and at 3-month follow-up demonstrated an occluded IMA and stabilization of the aneurysm sac size.

References

Jan 14, 2004·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·C J van MarrewijkUNKNOWN EUROSTAR Collaborators
Jan 27, 2004·Journal of Vascular Surgery·Jean-Pierre BecqueminHischam Kobeiter
Nov 14, 2006·Journal of Vascular Surgery·Petr StádlerMiroslav Spacek

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Citations

Jul 16, 2013·Annals of Vascular Surgery·Judith C Lin
Sep 6, 2014·Cardiovascular and Interventional Radiology·Raymond Chung, Robert A Morgan
Feb 11, 2012·Journal of Vascular Surgery·Abdulhameed AzizPatrick J Geraghty
Aug 31, 2010·Journal of Vascular Surgery·George A AntoniouColin D Bicknell
Sep 22, 2009·Seminars in Vascular Surgery·Frederik H W JonkerBart E Muhs
Feb 16, 2012·Surgical Innovation·Robert A BrenesShady H Macaron
Aug 4, 2020·Vascular and Endovascular Surgery·Mauricio Gonzalez-UrquijoMario Alejandro Fabiani
Jul 1, 2020·Angiologii︠a︡ i sosudistai︠a︡ khirurgii︠a︡ = Angiology and vascular surgery·G F MagomedovaA V Gavrilenko

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