Segments 1/6/7 ex vivo liver resection
with veno-veno bypass for caval sarcoma
00:08 SURGICAL PLANNING
04:19 EXPOSURE
06:17 DISSECTION
08:43 DIVISIONS
10:14 CAVAL RECONSTRUCTION
12:05 EX VIVO LIVER RESECTION
Case Description
- The patient was a 63 year old woman with a large caval sarcoma extending from the renal vein/caval confluence to the cavo-atrial junction, with anterior extension displacing the porta hepatis but without portal vein invasion.
- All 3 hepatic veins were obstructed, leading to Budd-Chiari syndrome, rendering all but an ex vivo approach unfeasible.
- The kidneys and lower extremities are draining largely though a posterior lumbar vein located at the level of the renal veins.
- An ex vivo liver resection with en bloc resection of cava, backbench liver flush, liver segments 1/6/7 resection with creation of liver segments 2/3/4ab/5/8 autograft was planned.
- The cava will be reconstructed with a 19 French ringed PTFE graft.
CT scans 2-days preop
Click to turn annotations on/off
CT scans 1-year preop
Click to turn annotations on/off
3D models
