Management and prevention of inferior vena cava injury during urology retro-laparoscopic surgery
Lin Haixing1, Lin Guowei1, Li Qinglin1, Zhen Qingshui1, Xie Jinlai1
1Department of Urology, Affiliated Hospital of Putian University, Putian 351100, China; 2The First Affiliated Hospital of Fuzhou General Hospital of Nanjing Military Region; 3The First Affiliated Hospital of Fujian Medical University
Abstract：Objective: To study the treatment and prevention of inferior vena cava injury during urology retro-laparoscopic surgery. Methods: The clinical data of 3 cases of inferior venous cava injury during urology retro-laparoscopic surgery were reviewed and analyzely. The inferior venous cava injury occurred in one case receiving the right adrenal pheochromocytoma resection, one case receiving retro-laparoscopic radical nephrectomy + regional lymph node cleaning, and one case receiving retro-laparoscopic nephrectomy for hydronephrosis. After the injury, effective measures were taken to repair the inferior vena cava. The injury in one case was sutured by 5-0 blood vessel suture line, and that in the rest 2 cases were dealt with 12-mm absorbable ligating clip cartridge (Lapro-Clip). Results: The injures in all three cases were repaired successfully under retro-laparoscopy. The operative time in one case given suture with 5-0 blood vessel suture line was 780 s, and that in the rest 2 cases given 12-min absorbable ligating clip cartridge was 420 s and 540 s respectively. All patients recovered with no air embolism, hemorrhage and other complications. Conclusions: If the injury of inferior venous cava is not severe with less bleeding and clear exposure, the injury can be repaired by 5-0 blood vessel suture line or 12-mm absorbable ligating clip cartridge under retro-laparoscopy.
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