Abstract
Laparoscopic right hepatectomy has become a standard procedure in specialized centers; however, tumor involvement of the inferior vena cava (IVC) is still considered a contraindication. Here, we describe a safe technique of totally laparoscopic right hepatectomy combined with IVC resection using an anterior approach. We performed 80 purely laparoscopic right hepatectomies by an anterior approach between January 2009 and January 2016. The case described here illustrates this procedure in a patient with bilateral colorectal liver metastases located in segments 8 and 9 involving the right anterior wall of the retrohepatic IVC. Right hepatectomy was performed by initial hilar dissection and ligation of vascular inflow followed by division of the hepatic parenchyma to expose the retrohepatic IVC. The right hepatic vein was divided using an endoscopic vascular stapler. As the involved portion of IVC could be isolated with the application of a single vascular clamp, the right IVC wall was divided using an endoscopic stapler. Thereafter, posterior mobilization of the right liver was performed. The surgical duration was 270 min and blood loss was 50 mL. The postoperative period was uneventful, and the resection in tumor-free margin. We devised here a safe and secure procedure to perform a totally laparoscopic right hepatectomy combined with IVC resection using an anterior approach.
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Bourdeaux, C., Fuks, D., Gayet, B. (2017). Totally Laparoscopic Right Hepatectomy Combined with En-Bloc Partial Resection of the Inferior Vena Cava. In: Pawlik, T., Weber, S., Gamblin, T. (eds) Case-Based Lessons in the Management of Complex Hepato-Pancreato-Biliary Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-50868-9_9
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DOI: https://doi.org/10.1007/978-3-319-50868-9_9
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