GAETANO CIANCIO, CHRISTOPHER HAWKE, MARK SOLOWAY

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Presentation transcript:

THE USE OF LIVER TRANSPLANT TECHNIQUES TO AID IN THE SURGICAL MANAGEMENT OF UROLOGICAL TUMORS GAETANO CIANCIO, CHRISTOPHER HAWKE, MARK SOLOWAY The Journal of Urology Volume 164, Issue 3, Pages 665-672 (September 2000) DOI: 10.1016/S0022-5347(05)67277-1 Copyright © 2000 American Urological Association, Inc. Terms and Conditions

Fig. 1 Exposure and vascular control required for cavotomy and removal of level 3 thrombus extending to just below major hepatic veins. The Journal of Urology 2000 164, 665-672DOI: (10.1016/S0022-5347(05)67277-1) Copyright © 2000 American Urological Association, Inc. Terms and Conditions

Fig. 2 Whole abdominal inferior vena cava with level 4 tumor thrombus extending into atrium is exposed by piggyback mobilization of liver off of retrohepatic inferior vena cava. The Journal of Urology 2000 164, 665-672DOI: (10.1016/S0022-5347(05)67277-1) Copyright © 2000 American Urological Association, Inc. Terms and Conditions

Fig. 3 Abdominal removal of small intra-atrial thrombus. Diaphragm is dissected off of suprahepatic inferior vena cava, Rummel tourniquet controls porta hepatis and clamps are applied to major hepatic veins as well as distal vena cava and left renal vein. Traction on tumor allows thrombus to be milked down and vascular clamp to be placed on suprahepatic inferior vena cava. The Journal of Urology 2000 164, 665-672DOI: (10.1016/S0022-5347(05)67277-1) Copyright © 2000 American Urological Association, Inc. Terms and Conditions

Fig. 4 Large upper pole renal or adrenal tumor encroaches behind retrohepatic inferior vena cava. The Journal of Urology 2000 164, 665-672DOI: (10.1016/S0022-5347(05)67277-1) Copyright © 2000 American Urological Association, Inc. Terms and Conditions

Fig. 5 Conventional mobilization of liver and vena cava as unit enables exposure of retrocaval right upper abdominal mass. The Journal of Urology 2000 164, 665-672DOI: (10.1016/S0022-5347(05)67277-1) Copyright © 2000 American Urological Association, Inc. Terms and Conditions