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.