Vascular

Femoral-Popliteal Bypass (Above Knee)

OPERATION: Femoral-Popliteal Bypass (Above Knee)
ANAESTHETIC: General / spinal anaesthesia
ANTIBIOTICS: IV antibiotics at induction if prosthetic graft
POSITION: Supine. Leg prepared circumferentially from groin to foot.

INDICATION:
Critical limb ischaemia / severe claudication. Preoperative duplex / CT angiography: superficial femoral artery occlusion, patent above-knee popliteal artery suitable for distal anastomosis. [Long saphenous vein / synthetic PTFE / Dacron graft planned].

PROCEDURE:
WHO Checklist performed.

FEMORAL EXPOSURE:
Vertical groin incision. Common femoral, superficial femoral, and profunda arteries dissected and slung.

POPLITEAL EXPOSURE (above knee):
Longitudinal incision above medial femoral condyle. Fascia incised. Popliteal fossa dissected between adductor muscles anteriorly and sartorius posteriorly. Popliteal artery separated from adjacent vein and nerve.

GRAFT PREPARATION: