Open repair of aortic aneurysms

So I'm going to talk now a little bit about open surgical repair of aortic aneurysms. So open repair is undoubtedly quite a big operation and it's performed under general anesthesia and you can really expect to be in an intensive care or a high dependency unit for one to two days after the operation and you'll probably be in hospital for about six or seven days after the operation. So you have to really think about a week in hospital and then about a month to recover from it. The actual operation involves a cut in the abdomen or laparotomy and we then move guts out of the way and get down to the aorta which is the main blood vessel in the body and dissect it free. Once it's free we're in a position to put clamps on at the top of the aorta and in the iliac arteries which supply the legs and that stops the blood flow in the main artery. We can then open the aneurysm and perform the repair and with the way we perform the repair is to take a fabric graft made out of something called Dacron and actually physically sew it into healthy aorta above and the healthy iliac arteries below, either as a tube graft or as a trouser leg bifurcated graft. We then take the clamps off, close over the aneurysm sac, close the abdomen and that's the end of the operation. The disadvantages of open aneurysm repair against stent repair is that you have a longest day in hospital and slightly higher risks at the time of surgery because it's a much bigger operation. The undoubted advantages however are once the aneurysm is repaired with an open technique that's usually the end of the problem forevermore and these have great durability and don't need long-term surveillance scanning. So once you've had the open operation done you leave hospital and you don't need to come to keep coming back to outpatient clinics to see your surgeon because there's no need for long-term surveillance. We normally do do a CT scan at five years after the operation just to keep an eye on the rest of the aorta and the rest of the arteries and if that's clear and it usually is then then that's the end of the problem.