The patient is a 75-year Caucasian male who presented to the vascular surgery service 4 years status post endovascular repair of an abdominal aortic aneurysm (AnnuxRx Stent graft). Since the time of his original procedure, the patient underwent coil embolization of his inferior mesenteric artery for Type II endoleak. As the endoleak did not resolve, the patient returned to the operating room for laparoscopic ligation of lumbar arteries contributing to the persistent endoleak. This video demonstrates development of a retroperitoneal working space via blunt dissection with a zero degree scope manipulated through a trocar adjacent to the left anterior superior iliac spine. In the course of exposing the abdominal aortic aneurysm, the peritoneum is inadvertently penetrated. Multiple techniques to address a peritoneal hole are demonstrated, including venting, placement of an endoloop, and even utilizing the defect as a pathway for instrumentation. Upon visualizing the aneurysm, multiple perforating vessels are identified, ligated, and transected. Once this is complete, the aneurysm sac is elevated anteriorly and a window free of lumbar vessels is visualized along the entire length of the posterior aspect of the aneurysm. The trocars are then removed and the procedure concluded. This video demonstrates that a laparoscopic approach is feasible for ligation of lumbar vessels contributing to a Type II endoleak following endograft placement for abdominal aortic aneurysm.