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Jornal Vascular Brasileiro

versão impressa ISSN 1677-5449versão On-line ISSN 1677-7301

Resumo

YOSHIDA, Ricardo de Alvarenga et al. Laparoscopic aortic surgery learning curve: experimental study in pigs. J. vasc. bras. [online]. 2008, vol.7, n.3, pp.231-238. ISSN 1677-5449.  http://dx.doi.org/10.1590/S1677-54492008000300008.

BACKGROUND: Laparoscopic aortic surgery (LAS) is evolving as a minimal invasive alternative technique for the treatment of abdominal aortic aneurysms and peripheral aortoiliac arterial disease. Few articles have objectively evaluated the technique learning curve in vascular surgery. OBJECTIVE: The aim of the present experimental study was to demonstrate surgical feasibility and evaluate each surgical step of LAS. METHODS: Between October 2007 and January 2008, two beginning surgeons attended laparoscopic courses and operated on six consecutive pigs with a total laparoscopic retroperitoneal aortic dissection and interposition of a Dacron tube graft in the infrarenal aortic segment. Both anastomoses were performed under total laparoscopic technique. RESULTS: All surgical time curves decreased along time: 45.9% in total surgical time, 85.8% in dissection time, 81.2% in aortic exposure, 55.1% in total cross-clamping, 71% in proximal anastomosis and 64.9% in distal anastomosis. CONCLUSION:This experimental study showed that satisfactory results with LAS were only reached after a long learning curve. However, this learning curve decreased along time, as experience with the technique, materials and non-stereoscopic vision improved. Vascular surgeons should attend practical courses and should have training opportunities in simulators and animals to achieve results similar to those of conventional surgery.

Palavras-chave : Video-assisted surgery; aorta; vascular diseases; learning; animal models.

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