Right Hepatectomy with Cava Resection and Oophorectomy

In situ cold perfusion and vena cava reconstruction with PTFE graft


00:11  Surgical Planning

03:32  Mobilization & Divide LRV

06:26  Portal Dissection

07:57  In Situ Cold Perfusion Setup

09:07  Liver Transection

10:44  Divide IVC & Specimen Removal

12:45  IVC Reconstruction & Closing

Case Description
  • The patient is a 42-year-old female with a sarcoma arising from the left ovary.
  • The tumour thrombus involved the left gonadal vein, the left renal vein, the cava lumen, and up to the right atrium. The liver right lobe was also congested due to the thrombus obstructing the right hepatic vein.
  • The surgical plan was a right hepatectomy with caudate, along with a cava resection and oophorectomy.
  • To reconstruct the vena cava in a bloodless field, an in-situ cold perfusion of the liver was set up.
  • The suprahepatic cava was divided obliquely to preserve the connection to the left-middle hepatic vein confluence. The infrahepatic cava was divided obliquely to preserve the right renal vein for reconstruction.
  • The vena cava was reconstructed with a ringed PTFE graft.
CT Scans (Venous)

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Specimen Model