Robot-Assisted Thoracofemoral Bifurcation Bypass

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INTRODUCTION: Thoracofemoral bypass surgery for occlusion of aortofemoral segment is a variant of choice for treatment of patients with impossibility of performing traditional aortofemoral bypass. The use of robot-assisted technologies in the formation of a proximal anastomosis permits to reduce the trauma of surgical access and to improve the results of surgical intervention. The article reports a case of a patient with occlusion of the aorto-iliac segment and total calcification of the infrarenal aorta, who underwent robot-assisted thoracofemoral bifurcation bypass surgery.

CONCLUSION: Use of modern technologies in the vascular surgery permits to reduce traumatization, minimize the effect of the human factor, improve visualization and freedom of movement and shorten the recovery period and the period of hospital stay.

作者简介

Vladimir Porkhanov

Scientific Research Institute — Ochapovsky Regional Clinical Hospital No. 1; Kuban State Medical University

Email: kkb1@mail.ru
ORCID iD: 0000-0003-0572-1395
SPIN 代码: 2446-5933

MD, Dr. Sci. (Med.), Professor

俄罗斯联邦, Krasnodar; Krasnodar

Aslan Zakeryayev

Scientific Research Institute — Ochapovsky Regional Clinical Hospital No. 1

Email: aslan.zakeryaev@gmail.com
ORCID iD: 0000-0002-4859-1888
SPIN 代码: 6519-8918

MD Cardiovascular Surgeon

俄罗斯联邦, Krasnodar

Roman Vinogradov

Scientific Research Institute — Ochapovsky Regional Clinical Hospital No. 1; Kuban State Medical University

Email: viromal@mail.ru
ORCID iD: 0000-0001-9421-586X
SPIN 代码: 7211-3229

MD, Dr. Sci. (Med.)

俄罗斯联邦, Krasnodar; Krasnodar

Tarlan Bakhishev

Scientific Research Institute — Ochapovsky Regional Clinical Hospital No. 1

编辑信件的主要联系方式.
Email: tarlan.bakhishev@yandex.ru
ORCID iD: 0000-0003-4143-1491
SPIN 代码: 9558-6940

MD, Cardiovascular Surgeon

俄罗斯联邦, Krasnodar

Gerey Khangereyev

Kuban State Medical University

Email: han.gerey@mail.ru
ORCID iD: 0000-0002-8667-2072
SPIN 代码: 5864-1298

Resident of the Department of Cardiology and Cardiac Surgery

俄罗斯联邦, Krasnodar

Sultan Butayev

Scientific Research Institute — Ochapovsky Regional Clinical Hospital No. 1

Email: dr.sultan@inbox.ru
ORCID iD: 0000-0001-7386-5986
SPIN 代码: 3900-4985

MD, Cardiovascular Surgeon

俄罗斯联邦, Krasnodar

Аnastasiyа Erastova

Kuban State Medical University

Email: kijnat@yandex.ru
ORCID iD: 0000-0002-4250-0893
SPIN 代码: 6583-3095

Resident of the Department of Cardiology and Cardiac Surgery

俄罗斯联邦, Krasnodar

Aleksandr Baryshev

Scientific Research Institute — Ochapovsky Regional Clinical Hospital No. 1; Kuban State Medical University

Email: A.barishev@icloud.com
ORCID iD: 0000-0002-6735-3877
SPIN 代码: 2924-1648

MD, Dr. Sci. (Med.)

俄罗斯联邦, Krasnodar; Krasnodar

参考

  1. Zelinskiy VA, Melnikov MV, Barsukov AYe, et al. An abdominal aortic calcification as a risk factor for cardio-cerebral events in patients with peripheral arterial disease. Klinitsist. 2012;(3–4):33–7. (In Russ).
  2. Köksal C, Sarikaya S, Zengin M. Thoracofemoral bypass for treatment of juxtarenal aortic occlusion. Asian Cardiovasc Thorac Ann. 2002;10(2):141–4. doi: 10.1177/021849230201000211
  3. Lin JC. The role of robotic surgical system in the management of vascular disease. Ann Vasc Surg. 2013;27(7):976–83. doi: 10.1016/j.avsg.2013.02.004
  4. Magomedova GF, Sarkhanidze YaM, Lepshokov MK, et al. Robot-assisted operations in vascular surgery. Angiology and Vascular Surgery. 2020;26(2):190–6. (In Russ). doi: 10.33529/ANGI02020202
  5. Mosoyan MS, Fedorov DA. Modern robotics in medicine. Translational Medicine. 2020;7(5):91–108. (In Russ). doi: 10.18705/2311-4495-2020-7-5-91-108
  6. Saaya ShB, Rabtsun AA, Popova IV, et al. Robotic-assisted operations for pathology of the aortoiliac segment: own experience. Angiology and Vascular Surgery. 2020;26(4):90–6. (In Russ.). doi: 10.33529/ANGIO2020409
  7. Stádler P. Role of the robot in totally laparoscopic aortic repair for occlusive and aneurysmal disease. Acta Chir Belg. 2009;109(3):300–5. doi: 10.1080/00015458.2009.11680429
  8. McCarthy WJ, Mesh CL, McMillan WD, et al. Descending thoracic aorta-to-femoral artery bypass: ten years' experience with a durable procedure. J Vasc Surg. 1993;17(2):336–348. doi: 10.1016/0741-5214(93)90419-M
  9. Jongkind V, Diks J, Yeung KK, et al. Mid-term results of robot-assisted laparoscopic surgery for aortoiliac occlusive disease. Vascular. 2011;19(1):1–7. doi: 10.1258/vasc.2010.oa0249

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1. JATS XML
2. Рис. 2. Вид на сформированный проксимальный анастомоз между синтетическим протезом и аортой. Адаптация проксимального анастомоза между нисходящей частью грудной аорты и синтетическим протезом

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3. Fig. 1. Position of the patient on the operating table (А). The layout of trocars and open surgical approaches (В).

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4. Fig. 3. Postoperative wounds after removal of drainages (after 3 days): front view (A), side view (B).

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5. Fig. 4. Three-dimensional reconstruction of multispiral computed tomography with intravenous contrast: before surgical intervention (A), after surgical intervention (B).

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