Reconstruction of Vena Cava

This technique is an alternative to associated cava reconstruction. It restores liver perfusion while working on the vena cava.

STEP 1

Open hepatic outflow by releasing the clamp on the suprahepatic vena cava. Clamp the vena cava again below the hepatic veins.

Liver Perfusion

STEP 2

Open hepatic inflow by releasing the tourniquet on the hepatoduodenal ligament. Now the retrohepatic cava is occluded while the liver is perfused.

STEP 3

The retrohepatic vena cava can now be resected. Reconstruction is accomplished with a Gore-tex interposition graft in an end-to-end fashion. Then release the cava clamp and the tourniquet on the lower cava.

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