From retroperitoneoscopic lumbar sympathectomy to total laparoscopic abdominal aorta surgery: how to learn.

The aim of this report is to describe the steps we followed to build up laparoscopic experience progressively towards total laparoscopic aorta surgery. The techniques of retroperitoneoscopic lumbar sympathectomy, hand-assisted laparoscopic aorta surgery and total laparoscopic aorta surgery are discussed and illustrated. Surgical tips and tricks and advice concerning selection of patients and surgical techniques are proposed. The 30-day morbidity and mortality rates of laparoscopic, standard open and endovascular abdominal aorta aneurysm repair were compared.