Background

Inferior Vena Cava (IVC) injury and minimally invasive management during laparoscopic and robotic surgery has been reported previously. We present a case of a 42 year female with history of laparoscopic roux-en-Y gastric bypass in 2009 and laparoscopic primary hiatal hernia repair in May of 2021, who suffered from postoperative odynophagia after her revisional procedure.

Methods

Including upper GI series, empiric GEJ dilation, and high resolution manometry failed to show a cause for her persistent symptoms. She was consented for a diagnostic laparoscopy, during which significant adhesions were encountered.

Results

During adhesiolysis, a tangential sharp injury to the IVC was made. The injury was able to be controlled using a figure of eight stitch with a prolene suture tied to pledgeted fibrillar.

Conclusions

This demonstrates a novel and new technique for control of major vascular injury in the reoperative field, where complete visualization of the injury is difficult.