Table VII. Surgical approaches for open aneurysm repair
| Transperitoneal |
| Advantages |
- Most rapid, greatest versatility
- Provides widest access
- Enables evaluation and treatment of concomitant intra-abdominal disease
|
| Disadvantages |
- Longer postoperative ileus
- Potential for greater fluid losses
- Difficulty with exposure and control for suprarenal aneurysms
- Higher incidence of incisional hernia
|
| Retroperitoneal |
| Advantages |
- Avoids hostile abdomen
- Facilitates suprarenal exposure and control
- Potential reduction of postoperative ileus
- Obesity
- AAA
- Horseshoe kidney
|
| Disadvantages |
- Poor access to right renal and iliac arteries
- Cannot evaluate intra-abdominal disease
- Flank bulge
|
AAA, Abdominal aortic aneurysm.
Adapted from Chaikof EL, Brewster DC, Dalman RL, Makaroun MS, Illig KA, Sicard GA, et al. The care of patients with an abdominal aortic aneurysm:
the Society for Vascular Surgery practice guidelines. J Vasc Surg 2009;50(Suppl):S2-49.