Beneficial use of the round ligament as a patch graft for vena cava reconstruction

Toru Ikegami, Mitsuo Shimada, Satoru Imura, Yuji Morine, Hirofumi Kanemura, Hiroki Mori, Yusuke Arakawa, Jun Hanaoka

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background/Purpose: The availability of an appropriate vascular graft is a significant concern in an extensive hepatic resection with part of the vena cava. Methods/Results: The patient had multinodular hepatocellular carcinoma, occupying the whole posterior segment with a tumor thrombus bulging inside the vena cava. At laparotomy, a segment of the round ligament was procured for use as a patch graft. After the mobilization of the right-side liver without taking down the short hepatic veins, parenchymal resection was completed with the use of a hanging maneuver. The hepatic vena cava was semitotally side-clamped, followed by resection of the caval wall with the tumor thrombus, resulting in an en-bloc resection. The procured round ligament was opened, trimmed, and sutured to the vena cava as a patch graft, followed by smooth reperfusion. Conclusions: The use of an opened round ligament as a venous patch graft is an easy and feasible technique in patch reconstruction of the vena cava.

Original languageEnglish
Pages (from-to)581-584
Number of pages4
JournalJournal of Hepato-Biliary-Pancreatic Surgery
Volume15
Issue number6
DOIs
Publication statusPublished - Nov 21 2008
Externally publishedYes

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Round Ligaments
Venae Cavae
Transplants
Liver
Thrombosis
Hepatic Veins
Laparotomy
Reperfusion
Blood Vessels
Hepatocellular Carcinoma
Neoplasms

All Science Journal Classification (ASJC) codes

  • Surgery
  • Hepatology

Cite this

Beneficial use of the round ligament as a patch graft for vena cava reconstruction. / Ikegami, Toru; Shimada, Mitsuo; Imura, Satoru; Morine, Yuji; Kanemura, Hirofumi; Mori, Hiroki; Arakawa, Yusuke; Hanaoka, Jun.

In: Journal of Hepato-Biliary-Pancreatic Surgery, Vol. 15, No. 6, 21.11.2008, p. 581-584.

Research output: Contribution to journalArticle

Ikegami, T, Shimada, M, Imura, S, Morine, Y, Kanemura, H, Mori, H, Arakawa, Y & Hanaoka, J 2008, 'Beneficial use of the round ligament as a patch graft for vena cava reconstruction', Journal of Hepato-Biliary-Pancreatic Surgery, vol. 15, no. 6, pp. 581-584. https://doi.org/10.1007/s00534-007-1319-1
Ikegami, Toru ; Shimada, Mitsuo ; Imura, Satoru ; Morine, Yuji ; Kanemura, Hirofumi ; Mori, Hiroki ; Arakawa, Yusuke ; Hanaoka, Jun. / Beneficial use of the round ligament as a patch graft for vena cava reconstruction. In: Journal of Hepato-Biliary-Pancreatic Surgery. 2008 ; Vol. 15, No. 6. pp. 581-584.
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AU - Shimada, Mitsuo

AU - Imura, Satoru

AU - Morine, Yuji

AU - Kanemura, Hirofumi

AU - Mori, Hiroki

AU - Arakawa, Yusuke

AU - Hanaoka, Jun

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AB - Background/Purpose: The availability of an appropriate vascular graft is a significant concern in an extensive hepatic resection with part of the vena cava. Methods/Results: The patient had multinodular hepatocellular carcinoma, occupying the whole posterior segment with a tumor thrombus bulging inside the vena cava. At laparotomy, a segment of the round ligament was procured for use as a patch graft. After the mobilization of the right-side liver without taking down the short hepatic veins, parenchymal resection was completed with the use of a hanging maneuver. The hepatic vena cava was semitotally side-clamped, followed by resection of the caval wall with the tumor thrombus, resulting in an en-bloc resection. The procured round ligament was opened, trimmed, and sutured to the vena cava as a patch graft, followed by smooth reperfusion. Conclusions: The use of an opened round ligament as a venous patch graft is an easy and feasible technique in patch reconstruction of the vena cava.

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