Loving the Liver

Dr. Movahedi, the liver transplant surgeon, started his procedure at 10:30 this morning and finished up at 3:45. He was "very pleased" with the results, and when I asked if it was what he was expecting, he said, "It went better than he expected". Don't worry, I made him pinkie swear that he wasn't lying.

He said the tumor was completely wrapped around the caudate lobe, followed the portal vein down by the stomach and duodenum (beginning of small intestine connected to the stomach), and was pushing (not growing into) the right lobe (like a finger poking into a water balloon). They worked slowly, mm by mm chiseling the tumor away, and separating the tissue. Once they separated the tissue, he said he could pull the tumors out in one piece, and with some ease. He said there was less mucin than he expected, and that it looked localized around the tumors. He said it was a good thing he could get the tumor out now because it would have eventually squeezed off the duodenum and prevented Nate's stomach from emptying.

The Dr. drew the picture, I just labelled it. 

Now for the miracle of it.....yes, I said MIRACLE!!!

Nate has an anatomical abnormality (from birth), that about 5% of the population has. The liver is normally fed oxygen-rich blood through the hepatic artery, which has a right and a left branch. It lies right next to the portal vein (where the tumor had grown along), then splits into the left and right branch. These two branches bring oxygen to the different lobes of the liver. Instead of having both branches, Nate was born with only the left branch, and a gastric artery compensated to supply the upper part of the liver with oxygen-rich blood. In other words, an artery from his stomach feeds the liver with oxygen. I asked if it was consequential, and he said, "It was actually ideal". Because he was missing the right branch of the artery, it made it less complex because they didn't have to work around a major artery as they removed the tumor. The tumor could have also compromised the artery. 

"Ideal", "very pleased", and "better than expected" aren't words that we hear very often. Nate still has a long way to go in this procedure, but I'm grateful that this part is done and that the outcome is good. The colo-rectal surgeon, Dr. Maykel,  started on the lower pelvis as soon as the upper abdomen was complete. It could be 5 or 6 more hours before they close him up. Dr. Lambert also let me know that she's still undecided whether she will administer the HIPEC. This isn't surprising because at that point, she hadn't started exploring the lower abdomen.

my stopwatch....plus 90 minutes

Stay tuned! Grateful for anatomical abnormalities and an ever watchful Father in Heaven.