AAA 3. Video Presentation: Open Paravisceral Aneurysm Repair

Abstract

Aortic disease is among the top 20 leading causes of death in the United States. The open repair of abdominal aortic aneurysm was first described in 1952 and since then has been the “gold standard,” but with the newer endovascular procedures being less invasive, its use has decreased. In 2014, Dua et al1Dua A. Upchurch Jr., G.R. Lee J.T. Eidt J. Desai S.S. Predicted shortfall in open aneurysm experience for vascular surgery trainees.J Vasc Surg. 2014; 60: 945-949Abstract Full Text Full Text PDF PubMed Scopus (47) Google Scholar raised concerns that the volume of open aneurysm repair procedures is no longer conducive to an adequate vascular trainee education and that by 2020, vascular trainees are expected to do half of the open aneurysm repair cases that were done in 2010. The purpose of this video presentation is to keep the newer vascular surgeons in touch with this procedure because the next generation will require the use of high-fidelity simulation systems, the creation of a dedicated open repair vascular fellowship, or a combination of these approaches. After consent and deidentification, we used a high-definition LoupeCam (VizVOCUS Inc, Scottsdale, Ariz) to make a video of the surgical procedure. We also did a retrospective review of the patient’s chart and images. As part of our new project, creating an open surgical technique video library, we presented a case of a supraceliac aneurysm that required a retroperitoneal open abdominal aortic aneurysm repair. We reviewed why this was the surgical option and developed a surgical steps video of the procedure. In the endovascular era, there are still cases in which an open procedure can be the shortest and safest option. There is also need for options to train the next generation of surgeons in open procedures. This combination of a case presentation with surgical technique and procedural video can be one of the options to include in open surgical technique training.