Right hepatectomy with nephrectomy / adrenalectomy
In situ cold perfusion and vena cava reconstruction with PTFE graft
00:07 SURGICAL PLANNING
02:36 INCISION & MOBILIZATION
05:14 Parenchymal transection
05:55 In situ perfusion
07:20 Caval reconstruction
Case description
- A 45 year old woman was found with adrenocortical cancer superior to the right kidney.
- CT scans showed cancer encroached upon retrohepatic vena cava, reaching the middle and left hepatic vein confluence.
- Surgical planning suggested splitting the liver from the M/RHV groove to the gallbladder fossa, leaving the caudate lobe attached to the vena cava.
- The right lobe would then be removed, with the caudate lobe and the section of vena cava it is attached to, along with the right kidney and cancer specimen.
- The vena cava would then be reconstructed with a ringed PTFE graft while the remnant liver is under in situ cold perfusion.
CT scans (venous phase)
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