Injury to the right phrenic nerve can cause serious problems, including paralysis of the right hemidiaphragm and respiratory failure, which is an extremely severe complication of any surgical intervention in the suprahepatic
inferior vena cava .
After complete mobilization of the liver and incision of the retroperitoneum that covers the infrahepatic IVC and the left wall of the retrohepatic IVC, the suprahepatic
and infrahepatic IVC were isolated and encircled with vascular tapes easily in case of possible temporary total hepatic blood occlusion.
Budd Chiari syndrome is a rare disorder resulting from hepatic venous outflow tract obstruction anywhere from the small hepatic veins to the suprahepatic
inferior vena cava.
Introduction of an occlusion balloon through the cavotomy has also been described in 13 cases of level II and III thrombus.[sup.9] Suprahepatic
balloon positioning is accomplished with the aid of transesophageal echocardiography (TEE).
The explant study evidences the presence of a single lesion confined to the liver corresponding to the FHCC, with borders of hepatic hilum and suprahepatic
section free of tumor, not identifying vascular invasion, perineural, lymphatic, nor lymph node, so resection of regional lymph nodes was not necessary.
This success of balloon angioplasty in China is likely attributable to the etiology of BCS in the Asian population; BCS in the Asian population is usually associated with suprahepatic
stenosis of the IVC and therefore TIPS is not therapeutic [14, 15].
Of note, during the explant, when we started cutting the suprahepatic
cava, after clamping vessels, and cutting PV and infrahepatic IVC, due to the weight of the liver, RHV area tore and got retracted in the clamp.
Briefly, in donor operation, the suprahepatic
vena cava, infrahepatic vena cava, and portal vein were mobilized.
Compared with purely laparoscopic left lateral sectionectomy, the learning curve to perform complex surgeries is shorter with robotic assistance, and surgeons do not need abundant laparoscopic experience to perform surgical robotic techniques.[sup] However, it was somewhat more difficult to maintain the distance and angle between the mechanical arms from occlusions, especially when dissecting the left triangular ligament, falciform ligament, or suprahepatic
Abel et al., "Preoperative multivariable prognostic models for prediction of survival and major complications following surgical resection of renal cell carcinoma with suprahepatic
caval tumor thrombus," Urologic Oncology: Seminars and Original Investigations, vol.
** A midline incision with a median sternotomy was used in patients with cephalad suprahepatic
IVC tumor extension.
Results of the CTA concluded a diagnosis of scimitar syndrome based on a partial anomalous pulmonary venous return of the right upper, middle, and lower lobes into the suprahepatic
IVC (Figure 2) by way of a large anomalous scimitar vein.