COMPARATIVE ANALYSIS OF THE EFFECTIVENESS OF MINI-LAPAROTOMY AND ROBOT-ASSISTED APPROACHES IN SURGERY OF THE INFRARENAL AORTIC SEGMENT gvkg2024@mail.ru

 

COMPARATIVE ANALYSIS OF THE EFFECTIVENESS OF MINI-LAPAROTOMY AND ROBOT-ASSISTED APPROACHES IN SURGERY OF THE INFRARENAL AORTIC SEGMENT

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Russia

Poster Exhibition only

Surgical treatment of aneurysms and occlusive-stenotic lesions of the infrarenal aorta remains a complex task, particularly when determining the optimal surgical access.

The study included 120 patients diagnosed with either aneurysm or occlusion of the infrarenal aorta who underwent surgery between 2021 and 2025. Group I (robot-assisted reconstruction) – 49 patients. Group II (mini-laparotomy approach) – 71 patients. The following parameters were compared: duration of surgery, volume of intraoperative blood loss, conversion rate, and intra- and postoperative complications.

Intraoperative and postoperative complications occurred in 32.6% of patients in Group I and in 4.2% in Group II (χ² = 19.7; p<0.0001). In Group I, complications included: Graft thrombosis – 10.2%, Bleeding – 8.2%. In Group II: Anterior abdominal wall abscess – 4.2%. The mean duration of surgery was 142.3±12.6 minutes in Group I and 268±19.2 minutes in Group II (p<0.0001). Conversion to open surgery was required in 3 patients (9.7%) in Group I; no conversions were observed in Group II (Fisher’s exact test, p = 0.021). Mean intraoperative blood loss was 475.8±80.2 ml in Group I and 970±140.5 ml in Group II (p<0.0001).

Despite the higher complication rate and frequency of conversions associated with robot-assisted surgery (OR 10.9; 95% CI: 2.9–40.6), this technique significantly reduces both operative time and intraoperative blood loss. The mini-laparotomy approach demonstrates more stable and safer outcomes in standard procedures and may be preferable in settings where access to robotic technology is limited.