Jornal Vascular Brasileiro
https://www.jvascbras.org/article/doi/10.1590/S1677-54492010005000004
Jornal Vascular Brasileiro
Case Report

Cirurgia aórtica totalmente laparoscópica para tratamento de isquemia crítica de membros: relato do primeiro caso no Brasil

Total laparoscopic aortic surgery for treatment of limb critical ischemia: report of the first case in Brazil

Ricardo de Alvarenga Yoshida; Winston Bonetti Yoshida; Hamilton de Almeida Rollo; Ralf Kolvenbach; Rodrigo Gibin Jaldim; Fernando Cordeiro Pimentel; Aline Helena Gonzáles Fares

http://dx.doi.org/10.1590/S1677-54492010005000004 J Vasc Bras, vol.9, n1, p.66-73, 2010
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Resumo

A cirurgia videolaparoscópica (CVL) vem evoluindo como alternativa cirúrgica menos invasiva para o tratamento da doença aterosclerótica oclusiva aortoilíaca. O objetivo deste relato de caso foi demonstrar os resultados da primeira cirurgia aórtica totalmente laparoscópica relatada no Brasil para o tratamento da doença oclusiva aortoilíaca em paciente com isquemia crítica. Os tempos cirúrgicos totais de dissecção e exposição da aorta antes do clampeamento, exposição retroperitoneal da aorta, clampeamento total e da anastomose proximal com técnica totalmente laparoscópica foram de 220 minutos, 15 e 27 minutos, 42 minutos, 110 minutos e 78 minutos, respectivamente. A técnica videolaparoscópica é mais uma ferramenta minimamente invasiva, viável, segura e eficaz para o tratamento da doença oclusiva aortoilíaca extensa. Ela, que nada mais é do que a cirurgia convencional realizada sob visão laparoscópica, tem bons resultados a longo prazo, que se associam à elegância técnica.

Palavras-chave

Cirurgia videoassistida, aorta, doenças vasculares, aterosclerose

Abstract

Laparoscopic surgery has been increasingly used as a less invasive surgical option for the treatment of aortoiliac occlusive atherosclerotic disease. The objective of this case report was to describe the results of the first total laparoscopic surgery conducted in Brazil for the treatment of the aortoiliac occlusive disease in a patient with critical ischemia. Total time of surgery, time of aortic dissection and exposure before clamping, time of retroperitoneal exposure of the aorta, and time of total clamping and proximal anastomosis using total laparoscopic technique were 220 minutes, 15 and 27 minutes, 42 minutes, 110 minutes, and 78 minutes, respectively. The laparoscopic technique is an additional minimally invasive tool, being feasible, safe, and effective for the treatment of extensive aortoiliac occlusive disease. This technique, which is nothing more than a conventional surgery performed under laparoscopic viewing, brings good long-term results associated with technical elegance.

Keywords

Video-assisted surgery, aorta, vascular diseases, atherosclerosis

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