[Anatomicosurgical research on isolating the retrohepatic segment of the vena cava inferior]

The retrohepatic segment of the inferior vena cava is considered of major importance in the surgical management of both thoracoabdominal trauma and neoplasms involving the venous wall. Twenty autopsies and 10 anatomical specimens were employed to examine the patterns of the avascular inter-hepato-caval median space. For the isolation and ligation of the hepatic veins a rubber snare was inserted into the avascular plane assuring a right tension of the vasculo-parenchymal lamina which attracts the liver to the vena cava. The number and the course of the hepatic veins were clearly identified. Authors' experience, coupled with a critical review of the literature, confirms that successful isolation of the believed surgically inaccessible retrohepatic vena cava and hepatic veins may represent a suitable approach for major injuries or neoplasias of these structures.