Laparoscopic aortorenal bypass: a feasibility study

PURPOSE: To demonstrate the technical feasibility of laparoscopic aortorenal bypass in an acute porcine model. MATERIALS AND METHODS: An aorta-to-left renal artery bypass using an interposition Dacron graft was performed in five pigs. Intracorporeal laparoscopic free-hand suturing and knot-tying were employed exclusively. Renoprotective in-situ regional hypothermia was achieved intracorporeally by infusing ice-cold heparinized saline into the renal artery using a balloon catheter. RESULTS: The mean total surgical time was 325 minutes, and the mean renal ischemia time was 61 minutes. The end-to-side graft-to-aorta and end-to-end graft-to-renal artery anastomosis times were 34 minutes and 40 minutes, respectively. The mean estimated blood loss was 66 mL. On revascularization, prompt reperfusion of the kidney and Doppler-confirmed pulsation of the renal artery was noted. Graft patency was confirmed on autopsy. CONCLUSION: Laparoscopic aortorenal bypass is feasible. This study represents the initial report in the literature. A long-term animal survival study is planned.