Name of the Procedure:

Revision, femoral anastomosis of synthetic arterial bypass graft in groin, open; with autogenous vein patch graft.

Summary

This surgery involves correcting or repairing a synthetic arterial bypass graft in the groin area by using a patch made from the patient’s own vein. The procedure is done through an open surgical approach.

Purpose

The procedure addresses issues such as blockage or malfunction of a synthetic arterial bypass graft located in the groin. The goal is to restore proper blood flow and function, relieving symptoms like poor circulation and pain.

Indications

• Symptoms of graft failure such as leg pain, swelling, or ulcers.
• Diagnostic tests showing graft occlusion or narrowing.
• Patients with symptoms of peripheral arterial disease not responsive to non-surgical treatments.

Preparation

• Patients may need to fast for a specific period before the surgery.
• Adjustments to medications, particularly blood thinners, will be advised.
• Pre-operative diagnostic tests such as ultrasound, CT scan, or angiography to assess the affected area.

Procedure Description

1. The patient is placed under general anesthesia.
2. An incision is made in the groin area to expose the synthetic arterial bypass graft.
3. The problematic section of the graft is identified.
4. A segment of the patient’s own vein, often taken from the leg, is prepared for use as a patch.
5. The vein patch is sewn onto the graft to repair the affected area.
6. The incision is closed, and a dressing is applied.

Tools used include surgical instruments for making the incision, suturing equipment, and monitoring devices. General anesthesia is administered to ensure the patient is comfortable and pain-free during the procedure.

Duration

The procedure typically takes around 2 to 3 hours, depending on the complexity.

Setting

The surgery is performed in a hospital operating room.

Personnel

• Vascular Surgeon
• Anesthesiologist
• Surgical Nurses
• Scrub Technicians

Risks and Complications

• Common risks: Infection, bleeding, graft occlusion.
• Rare risks: Allergic reactions to anesthesia, blood clots, nerve damage.
• Complications are managed with medication, additional surgery, or other medical interventions.

Benefits

• Improved blood flow and circulation in the affected limb.
• Relief from symptoms like pain and swelling.
• Enhanced mobility and quality of life.

Benefits can often be realized within weeks to a few months post-surgery.

Recovery

• Post-operative care includes monitoring in a hospital setting for a few days.
• Instructions may involve wound care, activity restrictions, and taking prescribed medications.
• Recovery time can range from several weeks to a few months.
• Follow-up appointments for monitoring and additional imaging tests may be needed.

Alternatives

• Non-surgical options such as medication or lifestyle modifications.
• Endovascular procedures like angioplasty or stenting.
• Pros of alternatives include less invasiveness, while cons may include lower effectiveness or not being suitable for all patients.

Patient Experience

• During the procedure: The patient is under general anesthesia and will not feel anything.
• After the procedure: Expect some pain and discomfort at the incision site, managed with pain medications.
• Patients may also experience swelling and bruising which will decrease over time.
• Comfort measures include adequate pain management and support for mobility during recovery.