Minimally Invasive Approach to the Supradiaphragmatic Inferior Vena Cava: Total Thoracoscopic Caval Isolation. Issue 2 (March 2014)

• Record Type: Journal Article
• Authors: Hui, Dawn S.; Gill, Inderbir S.; Cunningham, Mark J.
• Is Part Of: Innovations. Volume 9:Issue 2(2014)
• Page Start: 145
• Page End: 147
• Publication Date: 2014-03
• Subjects: Thoracoscopy -- Inferior vena cava -- Renal cell cancer -- Thrombectomy; Cardiovascular system -- Surgery -- Periodicals; Heart -- Surgery -- Periodicals; Blood-vessels -- Surgery -- Periodicals; Chest -- Surgery -- Periodicals; Thoracic Surgical Procedures -- methods -- Periodicals; Vascular Surgical Procedures -- methods -- Periodicals; Thorax -- Chirurgie -- Méthodologie -- Périodiques; Vaisseaux sanguins -- Chirurgie -- Méthodologie -- Périodiques; Blood-vessels -- Surgery; Chest -- Surgery; Periodicals; 617.41
• DOI: 10.1097/imi.0000000000000063
• Languages: English
• ISSNs: 1556-9845

Abstract

Minimally invasive techniques for cardiac operations have evolved in safety and popularity. To our knowledge, a thoracoscopic technique for control of the inferior vena cava (IVC) has not been previously described. We report a case of a right renal cell cancer with tumor extension into the IVC. Total thoracoscopic isolation and occlusion of the IVC were performed. Intraoperative real-time transesophageal echocardiography confirmed complete cessation of caval flow upon cinching the Rummel tourniquet. As extensive intra-abdominal operations are more often being attempted laparoscopically or robotically, video-assisted thoracoscopic IVC occlusion for proximal control for tumors extending into the cava can be achieved to offer a minimally invasive thoracic approach.