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RENAL ARTERY STENTING CHALLENGING
Kolvenbach R. 1, Shifrin E. 2, Witz M. 2, Yoshida R. 3
1 Department of Vascular Surgery and Endovascular Therapy, Augusta Hospital and Catholic Clinics, Duesseldorf, Germany
2 University of Tel Aviv and ES Vascular, Haifa, Israel
3 University of Botucatu, Botucatu, Brasil
Total laparoscopic and laparoscopic assisted techniques can be used to perform a renal bypass or to accomplish a debranching procedure. The authors describe thier experience and the operative technique of total laparoscopic renal and visceral artery bypass. Alternatively the laparoscopic exposure in combination with the VORTEC technique of M. Lachat is described. We now have the means to perform these complex operations in patients with juxta – and suprarenal aneurysms as well as in cases with occlusive disease. According to the authors’ experience laparoscopic assisted debranching of the abdominal aorta is feasible reducing the need for larger incisions in patients with more complex cases of aortic stent grafting. Recent technological advances like suture less endovascular anastomotic techniques and stapling technology greatly reduce operating times and technical complexity of the laparoscopic assisted debranching procedures.