Actually vena cava ligation is a last resort procedure.  When removing the
right adrenal gland it is usually possible to remove it completely with
the aid of surgical magnification loupes.  If/when there is a laceration
to the wall of the vena cava it is much better to repair the vessel wall
with sutures.  It is also possible to remove a section of the vena cava
with the adrenal gland then to suture the 2 ends of the vena cava back
together.  Vena cava ligation is not a hard procedure, but survival
depends on colateral circulation, a healthy heart, and some luck.
 
IMO it would be better to invest in a pair of surgical loupes, Debakey
vascular clamps, Debakey vascular forceps, and vascular sutures instead
of lasers or cyro units.
 
Hope that helps,
Jerry Murray, DVM
[Posted in FML issue 3722]