METHOD FOR ISOLATED LEFT-SIDED LOBAR ARTERIO-UMBILICAL LIVER PERFUSION IN AN EXPERIMENT Russian patent published in 2022 - IPC G09B23/28 A61B17/00 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, in particular to surgery, oncology, transplantology. Cadaveric liver exteriorization is performed. The portal vein is mobilized, one’s own hepatic artery, their branches and the retro-hepatic segment of the inferior vena cava, as well as the short hepatic veins that flow into the inferior vena cava are ligated and crossed. Next, the umbilical vein is mobilized in the round ligament of the liver and its recanalization is performed. The ends of the arteries in the round ligament are sealed. Then a cholecystectomy is performed. A venous cannula with an external diameter of 6 to 12 mm is installed and fixed in the umbilical vein. Next, an arterial cannula with a diameter of 2 to 4 mm is installed in the left branch of its own hepatic artery (OHA). Then a vascular turnstile is applied to the left branch of the OHA for sealing. The left branch of the portal vein (PV) is sealed to prevent perfusate leakage. After that, sealing is performed at the level of the terminal section of the intermediate and left hepatic veins, or in the presence of their common trunk. After that, a perfusion circuit is formed by connecting the inflow system, from the perfusion tank to the drug, to the cannula in the left branch of the OHA, the outflow system, from the drug to the reservoir, to the cannula in the umbilical vein. The circuit also includes tanks with perfusion solution and for collecting it at the outlet of the circuit, a perfusion pump, a thermostatic bath and connectors. Then, to determine the interlobular border of the liver, a solution of a water-soluble dye in a volume of 20 to 150 ml is injected bolus into the arterial cannula. Further, the identified interline boundary is marked with X-ray-positive objects. After that, isolated left-sided lobar arterio-umbilical perfusion of the liver is performed in the mode: perfusate flow rate 110-350 ml/min, duration 20-60 min, perfusate temperature 4-430°C. Further, during perfusion, in order to control the spread of perfusate in the parenchyma and possible leakage, a water-soluble X-ray contrast solution with a total volume of 100-150 ml is injected and fluoroscopy is performed. After that, the liver preparation is examined.

EFFECT: method makes it possible to improve the treatment of multiple mono- and bilobate liver lesions, as well as to create a basis for the development of new transplantation (“ex vivo”) technologies in abdominal surgery.

1 cl, 1 dwg, 2 ex