Surgical shunt for liver isolation

Surgery – Devices transferring fluids from within one area of body to...

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604101, 604158, A61M 100

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active

049502263

ABSTRACT:
A shunt for isolating the liver and hepatic veins from normal blood reperfusion into the inferior vena cava during trauma and similar surgical operations includes an outer tube with a first inflatable balloon at one end and a second inflatable balloon at an intermediate location with multiple openings spaced along the tube between the second cuff and the opposite end, and an inner tube telescopically movable within the outer tube with plural sealing O-rings spaced therealong in correspondence to the openings in the outer tube. During surgery, the balloon end of the tube is inserted and advanced upwardly in the inferior vena cava through a venotomy formed at a selected location, either above or below the renal veins. The first balloon is positioned within the right atrium of the heart, inflated, and then drawn backwardly to seat in sealing engagement at the atrial-caval opening. Alternatively, the first balloon may be positioned and inflated within the supradiaphragmatic cava. The second balloon is sufficiently spaced to be disposed below the hepatic veins so that, when also inflated, the liver and hepatic veins are isolated from blood reperfusion into the inferior vena cava. Withdrawal of the inner tube opens one or more of the openings in the outer tube to allow normal reperfusion from the renal veins and the lower extremities into the interior of the outer tube for flow into the right atrium of the heart.

REFERENCES:
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patent: 4230108 (1980-10-01), Young
patent: 4696668 (1987-09-01), Wilcox
Theodore Schrock, M.D.; F. William Blaisdell, M.D. and Carleton Mathewson, Jr., M.D., "Management of Blunt Trauma to the Liver and Hepatic Veins," Arch. Surg., vol. 96, pp. 698-703 (May 1968).
Robert E. Allen, Jr., M.D. and F. William Blaisdell, M.D., "Injuries to the Inferior Vena Cava," Surgical Clinics of North America, vol. 52, No. 3, pp. 699-711 (Jun. 1972).
Donald D. Trunkey, M.D., G. Tom Shires, M.D., Robert McClelland, "Management of Liver Trauma in 811 Consecutive Patients,"Ann. Surg. vol. 179, No. 5, pp. 722-728 (May 1974).
W. Wilson Defore, Jr. M.D.; Kenneth L. Mattox, M.D.; George L. Jordan, Jr. M.D.; Arthur C. Beall, Jr., M.D., "Management of 1,590 Consecutive Cases of Liver Trauma," Arch. Surg., vol. 111, pp. 493-497 (Apr. 1976).
David B. Pilcher, M.D., P. Kent Harman, B.A., Ernest E. Moore, Jr. M.D., "Retrohepatic Vena Cava Balloon Shunt Introduced Via The Sapheno-Femoral Junction," The Journal of Trauma, vol. 17, No. 11, pp. 837-841 (Nov. 1977).
Ernest E. Moore, M.D., Ben Eiseman, M.D., Ernest L. Dunn, M.D., "Current Management of Hepatic Trauma," Contemporary Surgery, vol. 15, pp. 91-115 (Sep. 1979).

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