Risberg retroperitoneal approach to the abdominal aorta

Abstract

Abstract In a study of the best approach to the infrarenal abdominal aorta, 47 patients were compared retrospectively: 15 underwent a standard transperitoneal incision, 15 a retroperitoneal left flank incision and 17 a new modified lateral pararectus incision, the Risberg approach. Operating time, length of postoperative intubation and hospital stay, mortality rate, morbidity rate and cost were assessed. There was a significant reduction (P <0·05) in mean(s.d.) operating time (141(21) versus 198(41) min), intraoperative cross-clamping time (74(13) versus 104(46) min) and postoperative intubation time (6·5(8·0) versus 13·3(7·3) h) associated with the Risberg retroperitoneal incision compared with the left flank retroperitoneal route. There was also a significant decrease (P <0·02) in mean(s.d.) postoperative intubation time (6·5(8·0) versus 17·5(12·0) h), time after operation to discharge (11·0(2·4) versus 17·3(7·6) days) and hospital cost (£4885(670) versus £7732(580)) associated with the Risberg incision compared with the transperitoneal approach. The Risberg incision gives better access to the infrarenal abdominal aorta while maintaining the advantages of other retroperitoneal approaches. This technique is recommended as the incision of choice for the retroperitoneal approach to the aorta.