METHOD OF AUTOVENOUS PLASTIC RECONSTRUCTION OF CAVARENAL SEGMENT OF INFERIOR VENA CAVA Russian patent published in 2020 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to surgery. Tourniquets are applied on the vein of the remaining kidney and inferior vena cava, suprarenal resection of the vena cava within healthy tissues. Medial laparotomy is performed and accessed into the retroperitoneal space, the tumor is mobilized along the perimeter. Further, in the proximal direction, performing the mobilization to the level of the suprarenal portion of the inferior vena cava, wherein the distal mobilization boundary is performed to the infrarenal level of the inferior vena cava. Medial and lateral direction is followed by accessing the gates of the right and left kidneys, separating the lower hollow vein and the left renal vein and suppressing the vascular clamps. Aortocaval space is ligatured and transected right renal artery, lower vena cava is transected above left renal vein by 1 cm and by 5 cm above confluence of common iliac veins, mobilization and circular resection of renal and infrarenal segments of the inferior vena cava are performed. Thus, the surgical preparation is removed in a single unit with a tumor, a right kidney, a renal and infrarenal segments of the inferior vena cava. In ex vivo conditions, an acute cavarenal segment of an inferior vena cava is extracted in an acute way; an inferior vena cava is reimplanted by forming a single-row vascular suture at the level of a suprarenal end-to-end section. Left renal vein is reimplanted into the inferior vena cava with the use of a single-row vascular suture of the "end-to-end" type and recovering blood flow along the left renal vein, further, on the level of the infrarenal segment of the inferior vena cava, a single-row vascular suture of the end-to-end type is formed, and blood flow is restored along the inferior vena cava.

EFFECT: method enables improving the results of the surgical management of the patients with malignant neoplasms accompanying the renal and infrarenal segment of the inferior vena cava, reducing the risk of developing postoperative complications due to use of own tissues for reconstructing the inferior vena cava, increasing the frequency of radical resections and reducing the frequency of test operations accordingly.

1 cl, 1 ex, 10 dwg