Right Para Aortic Dissection

■ As on the left side, you start dissecting from the right common iliac vessels in a cranial direction to free the lateral and anterior surfaces of the vena cava then the medial part of the aorta up to the left renal vein.

■ All lymphatic tissue anterior, lateral, and posterior to the vena cava must be removed.

■ On the left side the lumbar veins are respected as much as possible.

■ Posterior vena caval dissection provides access to the interaortocaval nodes and facilitates their elevation from the perivertebral plane while sparing the main postganglionic nerves arising from the second or third right sympathetic ganglia.

■ The intervascular dissection is finished anteriorly between the two great vessels and up to the left renal vein.

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