Endoaneurysmorrhaphy with intraluminal straight graft placement in infrarenal abominal aortic aneurysm - Vascular Surgery

Infrarenal AAAs greater than 5 cm in diameter and aneurysmal neck angulation greater than 60° do not lend themselves to EVAR.

Perform median laparotomy from xiphoid down to symphysis, carrying the incision to the left of the umbilicus.

Tips:

1. Maintain adequate distance from the umbilicus and do not incise the skin tangentially as this runs the risk of wound edge necrosis.

2. If the incisdion damages the cartilage of the xiphoid, it may trigger heterotopic ossification in the scar. Therefore start the incision somewhat lateral to the xiphoid.