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Continue ReadingThe roof-top approach, part 4: aortic dissection
Step No 5: Dissect the proximal aorta What is between you and the proximal aorta is the left crus of the diaphragm. With your hand …
Continue ReadingThe roof-top approach, part 3: dissection & approach to the aorta
So you stand on the right side of the patient, you have made the roof-top incision and you are inside the peritoneal cavity. The lower …
Continue ReadingThe roof-top approach, part 2: skin incision
Roof-top approach is a totally abdominal approach to the suprarenal aorta. This means that the incision is an abdominal incision. And as the title says, …
Continue ReadingThe roof-top approach, part 1: patient’s position
So you need to repair a suprarenal aortic aneurysm or even a type IV thoracoabdominal aortic aneurysm. There are mainly three options: a. a retroperitoneal …
Continue ReadingThe roof-top approach to the suprarenal aorta
The open repair of a suprarenal abdominal aortic aneurysm is a demanding procedure as it requires suprarenal or even supraceliac aortic clamping. The traditional approach …
Continue ReadingThe best suture for lumbar arteries ligation
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Continue ReadingHow to close the divided diaphragm on a TAAA repair
Re-approximating the divided diaphragm after a left thoracoabdominal incision is not that easy. Running or interrupting suturing?
Continue ReadingGet distal control on a ruptured AAA
So you have dived into a lake full of blood from a ruptured AAA. And you have proximal control. Great! What you need now is …
Continue ReadingHow to get proximal control on a ruptured AAA
On an open repair of a ruptured abdominal aortic aneurysm (AAA) the main issue is the proximal control. How will the surgeon clamp quickly and …
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