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LAPAROSCOPIC CAUDATE RESECTION: HOW TO SAFELY MANAGE THE SPIEGEL/IVC INTERFACE WHEN THE HEPATOCAVAL SPACE IS OBLITERATED OR FUSED
Oscar A. Salirrosas Roncal
*, Hamed Harandi, Eduardo A. Vega, Ariana M. Chirban, Claudius Conrad
General Surgery and Surgical Oncology, Saint Elizabeth's Medical Center, Brighton, MA
BACKGROUNDMIS caudate lobectomy can be linked with important bleeding due to its abutment of major vessels. The risk could magnify with a fused hepatocaval space
PATIENT68-year-old female with colorectal adenocarcinoma having a liver metastasis in the caudate lobe. Received 4 cycles of neoadjuvant chemotherapy
TECHNIQUE3-D liver and port site modeling was performed. After control of portal venous branches, the hepatocaval space was dissected. Using scissors rather than energy reduced the risk of inadvertent thermal injury to the IVC
CONCLUSIONVirtual hepatectomy facilitates surgical planning. Low central venous pressure and management of hepatic vein branches are key for a successful dissection
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