Life-saving surgery

Life-saving surgery at Soroka

Life-saving surgery to remove a tumor and a rare surgical procedure to replace inferior vena cava were performed at Soroka 

Soroka Medical Center   
26 July 2017  

Sergei Yosefa of Be’er-Sheva, an oncology patient who suffered from a very large metastatic tumor in the abdominal cavity, underwent complex surgery to remove the tumor, which had penetrated the renal veins and the inferior vena cava.

The tumor took up most of the cavity and the walls of the inferior vena cava before its entrance to the liver area.
The tumor had also spread to the main artery that supplies blood to all of the stomach organs (SMA) and to additional veins that drain the blood from the stomach organs.
The inferior vena cava is one of the two main venous blood vessels that drain blood that is returned from all body tissues to the heart. The right atrium pumps the blood received into the right ventricle, and from there the blood moves through four main arteries to be oxygenated in the pulmonary alveoli.
The tumor Sergei had in the abdominal cavity had damaged the venous drainage of the lower body and damage to the venous drainage of the right kidney.
Despite the risk involved in complex surgery to remove this type of tumor, Sergei was taken into the operating at Soroka for a rare and life-saving procedure where an artificial implant is permanently connected and the tumor, including the part stuck in the inferior vena cava and its separation from the SMA, was removed in whole.

Before surgery, a great deal of preparatory work was done, including preparation of the Cardiothoracic Surgery Department staff in case during surgery the venous blood would need to be routed from the lower body through an external pump to bypass the area where part of the vena cava needed to be removed, in order to maintain the continuity of the venous return during surgery.
In the end, this proved unnecessary, and the tumor was removed along with the entire blocked segment of the inferior vena cava.

Prof. Solly Mizrahi, Director of the Department of Surgery A, said, “Due to the serious stenosis of the vein, which made it impossible for the blood to drain from the lower body and, at the same time, the need to maintain venous return of the right kidney into the vena cava, a rare and life-saving procedure was performed. An artificial implant (graft), a Gore-Tex tube, measuring 14 mm in diameter was connected permanently to the inferior vena cava before the area heavily affected by stenosis.”

Prof. Itzhak Avital, specialist in surgical oncology, hepatobiliary, pancreas, and HIPE surgery and director of Soroka’s Cancer Center, added, “This procedure created a segment of the inferior vena cava, which is made up of two tubes, one natural and a product that serves as a renal vein, and the other is artificial and wide. This is what enabled us to fully remove the lesion in this patient.
Beyond the procedure, the remaining function of right kidney was preserved, preventing serious edema from developing in the lower body, which would have occurred had the stenosis of the vena cava remained without the artificial drainage.”


Sergei Yosefa: “I would like to thank the medical staff for their professionalism and dedicated care. I’m happy that such skilled professionals treated me, and that I was fortunate enough to have Prof. Avital perform the surgery. I feel good, despite having undergone complex surgery.”

The surgery was a great success and Sergei was discharged from the hospital a few days later.


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