Laparoscopic management of operative vena cava injury

Major vascular injury can result from trocar placement, but it is a rare event during an intra-abdominal laparoscopic procedure. The authors report a major vena cava injury that occurred during a right adrenalectomy. The injury was managed entirely laparoscopically. Management of a major vascular injury occurring in such circumstances requires appropriate instruments and equipment, including a vascular clamp and good suction. Conversion to an open procedure is recommended if the injury cannot be safely resolved laparoscopically.