The main alternative approach to keeping high pressure blood away from the inside of the weakened end artery is to do a keyhole repair. This involves inserting a sleeve to line the inside of the aneurysm via the artery in the groin. The same kind of artificial artery used for an open repair is used but it is contained within a narrow flexible tube and has metal springs inside it. The tube with the artificial artery inside it is passed up the inside of the artery and passing up until the weakened part of the artery aneurysm is reached. The sleeve is then opened up and seals off the aneurysm from inside achieving the same thing as in open operation. The seal is achieved by metal springs, which are inside the artificial artery which squeeze it against the inside of the artery, so sealing off the aneurysm
The obvious advantage of the keyhole method is that it involves two small cuts in the groin rather than a large cut on the belly and is a much less major procedure in terms of the risks of surgery, time taken to recover and so on. Typically a person having an open repair will be in hospital so about ten days or so following the surgery and often requires a stay on the intensive care or high dependency unit. Even once they have been discharged it will take several months for them to recover fully. The keyhole repair is much more minor procedure; patients often can go straight back to the ward and usually go home a few days after the operation. So far it would seem that there is no contest between an open and a keyhole procedure.
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