VH04 - Early Feasibility of Robotic Lumbar Ligation for Persistent Endoleak after EVAR of FEVAR

Thursday, June 11, 2026

2:00 PM - 2:09 PM ET

Location: Hynes CC, Third Level, Ballroom A

Submitting & Presenting Author(s)

Camila R. Guetter, MD

Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA

Co-Author(s)

JW

Jacqueline E. Wade, MD

Resident physician
Department of Surgery, Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
Boston, Massachusetts

Senior Author(s)

Marc L. Schermerhorn, MD

Chief, Division of Vascular and Endovascular Surgery
Beth Israel Deaconess Medical Center
Boston, Massachusetts
Lars Stangenberg, MD, PhD

Assistant Professor of Surgery
Beth Israel Deaconess Medical Center
Boston, Massachusetts

Summary: This video demonstrates the early feasibility and perioperative safety of a robotic-assisted approach to lumbar and inferior mesenteric artery ligation for the treatment of persistent type II endoleaks associated with aneurysm sac enlargement after EVAR or FEVAR. Key steps include transperitoneal exposure of the infrarenal aorta, IMV identification and retraction, meticulous posterior dissection of the aneurysm sac from the anterior longitudinal spinal ligament, and sequential ligation of the IMA and lumbar arteries using a vessel-sealing device. Early institutional experience suggests this minimally invasive strategy is well tolerated, with low blood loss, short hospital stays, and the potential to avoid repeated embolization or open repair in select patients, especially those with multiple simultaneous feeding vessels.