Vascular Surgery · Vascular

Abdominal Aortic Aneurysm Repair (Open) (Ruptured)

OPERATION: Open Repair of Ruptured Abdominal Aortic Aneurysm
ANAESTHETIC: General anaesthesia — induction deferred until ready to incise
ANTIBIOTICS: IV antibiotics at induction
POSITION: Supine. Patient prepared and draped awake — abdomen and groins. Urinary catheter inserted pre-induction. Permissive hypotension (target ~70 mmHg systolic) maintained until proximal control achieved.

INDICATION:
Ruptured / suspected ruptured AAA. [CT confirmed / clinical diagnosis in extremis]. Large-bore IV access, arterial line, urinary catheter, cross-match. [Cell salvage in circuit].

PROCEDURE:
Patient induced only when team and scrub ready. Midline laparotomy. Small intestine retracted laterally by assistant. Retroperitoneum rapidly entered.

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