在肾水平以下的腹主动脉瘤治疗中,目前仍广泛使用Creech所倡用的经腹径路腹主动脉瘤内成形术和人造血管替代,然而多年来已认识到腹膜后径路有更大优点,本文乃就这一径路的具体操作要点、指征与优缺点进行复习。手术操作要点(1)体位:取右侧卧位,略后仰,用砂袋垫于左肩之后,使双肩联线与水平成90°角,但骨盆允其向后转动;可加用肾桥,以扩大肋缘与髂嵴间的距离。这种体位甚便于进入腹膜后和双侧腹股沟。(2)切口:可有多种选择。根据作者体会,在肾水平以下的主动脉显露中,以Risberg’s切口(腹部旁正中 In the treatment of abdominal aortic aneurysms below the renal level, there is still widespread use of transabdominal abdominal aortic aneurysm endoprosthesis and prosthetic vascular replacement as advocated by Creech, however, it has been recognized for many years that retroperitoneal pathways have greater advantages, This article is about the specific operation of this path points, indications and advantages and disadvantages of review. Operation points (1) position: take the right lateral position, slightly backwards, with a sandbag pad on the left shoulder, so that the horizontal line at a 90 ° angle, but the pelvis allows its backward rotation; , In order to expand the distance between the flange and the iliac crest. This position is very easy to enter the retroperitoneal and bilateral inguinal. (2) incision: There are many choices. According to the author’s experience, in renal aortic exposure below the level, with Risberg’s incision (abdominal next to the median