Two-stage surgery to repair a dissecting abdominal aortic aneurysm in a severely obese patient: Open bifurcated graft replacement after laparoscopic sleeve gastrectomy

Asian J Endosc Surg. 2016 May;9(2):149-51. doi: 10.1111/ases.12260.


With the increasing prevalence of severe obesity worldwide, surgical treatment for severely obese patients is becoming more popular. Bariatric surgery has occasionally been performed as a precursor to major operations for serious diseases to make these difficult surgeries safer for severely obese patients. We present the case of a severely obese patient with a dissected abdominal aortic aneurysm and left iliac artery aneurysm. Initially, we performed bariatric surgery on this patient to reduce perioperative risk and then subsequently performed bifurcated graft replacement. A 54-year-old man presented at our hospital for bariatric surgery before open abdominal aortic aneurysm repair. Laparoscopic sleeve gastrectomy was performed; 15 months later, the patient's weight and BMI had decreased from 139.0 kg to 97.6 kg and from 48.7 kg/m(2) to 34.2 kg/m(2) , respectively. Bifurcated graft replacement was performed safely without postoperative complications. Bariatric surgery was also effective in controlling the patient's blood pressure during the interval between surgeries.

Keywords: Abdominal aortic aneurysm; aortic dissection; bariatric surgery.

Publication types

  • Case Reports

MeSH terms

  • Aortic Aneurysm, Abdominal / complications
  • Aortic Aneurysm, Abdominal / surgery*
  • Aortic Dissection / complications
  • Aortic Dissection / surgery*
  • Blood Vessel Prosthesis
  • Blood Vessel Prosthesis Implantation*
  • Gastrectomy*
  • Humans
  • Laparoscopy*
  • Male
  • Middle Aged
  • Obesity, Morbid / complications
  • Obesity, Morbid / surgery*