AAA greater than 5 cm in diameter with aneurysmal neck angulation greater than 60°, which is why it is unsuitable for EVAR.
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Dynamic three-dimensional spiral CT image of the infrarenal abdominal aortic aneurysm (AAA)
![Dynamic three-dimensional spiral CT image of the infrarenal abdominal aortic aneurysm (AAA)]()
Soundsettings -
Laparotomy
![Laparotomy]()
Soundsettings Perform median laparotomy from xiphoid down to symphysis, carrying the incision to the left of the umbilicus.
Tips:
1. Maintain adequate distance from the umbilicus and do not incise the skin tangentially, as this runs the risk of wound edge necrosis.
2. If the incision damages the cartilage of the xiphoid, it may trigger heterotopic ossification in the scar. Therefore, start the incision somewhat lateral to the xiphoid.
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Opening the retroperitoneum
![Opening the retroperitoneum]()
Soundsettings After exploring the abdomen, mobilisation of the small intestine to the right and the transverse colon cranially. Coagulate smaller vessels and open the retroperitoneum slightly to the right of the right iliac axis, sparing the inferior mesenteric artery (AMI) and the lymphatic pad. The incision runs to the right alongside the AAA. Mobilize the duodenojejunal flexure.
Dissecting the iliac arteries and the aneurysm neck
Expose the right common iliac artery by dissecting directly on the vessel and sweep the preaortic l
Expose the right common iliac artery by dissecting directly on the vessel and sweep the preaortic l
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