Totally laparoscopic aortohepatic bypass for aortic debranching during endovascular thoracoabdominal aneurysm repair

Introduction. Endovascular grafting of the aorta is gaining widespread acceptance for treating aortic aneurysms. Pararenal aneurysms or thoraco-abdominal aneurysms may be a relative contra-indication for endovascular aneurysm repair (EVAR) unless visceral vessels can be debranched. Report. We describe a case of thoraco-abdominal aneurysm extending from the descending thoracic aorta to the level of coeliac artery. A totally laparoscopic retrograde aorto-hepatic bypass was performed in conjunction with endograff exclusion of the aneurysm and coverage of the coeliac artery ostium. Discussion. Laparoscopic debranching of visceral vessels extends the indications of EVAR.