CME credit is not offered for this activity.

This content is provided to members of SVS for free as a member benefit. If you are not a current member of SVS, click here for information on how to apply for membership.

Summary
This video demonstrates the early feasibility and perioperative safety of a robotic-assisted approach to lumbar and inferior mesenteric artery ligation for the treatment of persistent type II endoleaks associated with aneurysm sac enlargement after EVAR or FEVAR. Key steps include transperitoneal exposure of the infrarenal aorta, IMV identification and retraction, meticulous posterior dissection of the aneurysm sac from the anterior longitudinal spinal ligament, and sequential ligation of the IMA and lumbar arteries using a vessel-sealing device. Early institutional experience suggests this minimally invasive strategy is well tolerated, with low blood loss, short hospital stays, and the potential to avoid repeated embolization or open repair in select patients, especially those with multiple simultaneous feeding vessels.

Authors
Presenting Author: Camila R. Guetter, MD
Co-Author: Jacqueline E. Wade, MD
Senior Author: Marc L. Schermerhorn, MD
Senior Author: Lars Stangenberg, MD, PhD

Target Audience
All members of the vascular surgery field.

Price
SVS Member: Free
Non-Member: $35

Original video presented at VAM 2026

SVS Disclaimer
The opinions or views expressed on the SVS OnDemand platform are those of the faculty and do not necessarily reflect the opinions, recommendations, or endorsement of SVS. Participants should critically appraise the information presented and are encouraged to consult appropriate resources for information surrounding any product or device mentioned. Information presented, as well as publications, technologies, products and/or services discussed, are intended to inform the learner about the knowledge, techniques, and experiences of SVS faculty who are willing to share such information with colleagues. The SVS disclaims any and all liability for damages to any individual user for all claims which may result from the use of said information, publications, technologies, products and/or services and events.