Extended right hepatectomy with veno veno bypass
With caudate & caval resection, atrial thrombectomy, in situ cold perfusion, and caval reconstruction
00:16 SURGICAL PLANNING
- A 60-year-old female presented with hepatocellular carcinoma in the right lobe of a non-cirrhotic liver.
- It involved segments V, VI, VII, VIII, and extended into segment IVa as well.
- A tumour thrombus extended from the right hepatic vein, into the inferior vena cava, and up into the right atrium.
- The surgical plan was to perform an extended right hepatectomy, resection of segments I, V, VI, VII, VIII, and a portion of segment IVa. The inferior vena cava was divided at the right atrium and just above the renal veins.
- A veno-veno by pass circuit was set up to maintain hemodynamic stability during caval cross clamping.
- An in-situ cold perfusion was also set up to reconstruct the inferior vena cava and the left hepatic vein in a blood less field.
CT scans (Arterial phase)