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Innovations: Technology & Techniques in Cardiothoracic & Vascular Surgery:
doi: 10.1097/IMI.0000000000000063
Case Reports

Minimally Invasive Approach to the Supradiaphragmatic Inferior Vena Cava: Total Thoracoscopic Caval Isolation

Hui, Dawn S. MD*; Gill, Inderbir S. MD, MCh; Cunningham, Mark J. MD*

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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.

©2014 by the International Society for Minimally Invasive Cardiothoracic Surgery


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