J.Jpn. Surg. Soc.. 79(9): 1170-1172, 1978

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Report on the annual meeting

SURGERY FOR ANEURYSM OF THE ABDOMINAL AORTA: TECHNIQUE OF ANASTOMOSIS

In the surgical treatment for aneurysm of the abdominal aorta, it is desirable not to clamp the renal arteries during operation whenever possible, even if the lesion extends to just below their roots, because acute renal failure, frequently life-threatening, is the most common complication during the early postoperative period. In this situation, we anastomose routinely the proximal stump of the aorta with an end of vascular prosthesis in the following manner:
1. A clamp is placed on the aorta just below the roots of the renal arteries. The anterior wall of aneurysm about 2 cm apart from the clamp is completely cut off, while the posterior wall incompletely, i.e. only the intimal layer is severed.
2. The posterior aortic wall close to the clamp is anastomosed with the posterior prosthetic wall using mattress sutures with Teflon pledgets reinforced by a continuous suture. Then, anastomosis between the anterior walls of both is performed in the same fashion.
In addition to that, reconstruction of the inferior mesenteric artery is performed whenever possible because of potential occlusion of both internal iliac arteries.

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