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]