Laparoscopic and robotic aortic surgery

Minimally invasive approaches have taken the world of vascular surgery by storm, particularly endovascular techniques. Nevertheless, open surgical technique like the aortobifemoral bypass (AFB) remains an extremely ef ficacious and durable operation and is the procedure against which all other iliac procedures are benchmarked. However, if one thinks of an open procedure, like an endovascular procedure, as consisting of both a "delivery system" and a therapeutic component, the delivery system for aortobifemoral bypass remains unappealing and in many instances a very high-risk operation in patients with signi ficant comorbidities. Consequently, endovascular management of aortoiliac disease has moved to the front line of the treatment algorithm. Being able to deliver the results of open surgical techniques in a more acceptable manner is possible today both by totally laparoscopic or robotic abdominal procedure. This not only reduces the convalescence period but also leads to fewer operative complications than standard techniques. This chapter discusses current minimally invasive laparoscopic and robotic techniques in aortic surgery.