Laparoscopic Retroperitoneal Washout of an Infected Aorto-Bifemoral Graft: A Novel Technique

Abstract

Aortic prosthesis infection is a challenging complication of aortic bypass surgery with high morbidity and mortality. We report a laparoscopic washout of an infected aorto-bifemoralperigraft collection with radiologic guidance using a nephroscope. The track was dilated with Endouro balloon and sheath to allow access. The cavity was copiously irrigated with saline and aqueous iodine solution. Surveillance computed tomography scan showed no new collection, thrombosis, aneurysm or fistula from the bypass graft. Bilateral lower limbs remained well perfused. Minimally invasive retroperitoneal washout may be a viable alternative to graft explant and extra-anatomical bypass in aortic graft infection.