Targeting Liver Tumors with Oncolytic Viruses via the Hepatic Artery

To isolate the hepatic artery, first, use two moistened cotton applicator swabs to gently transfer the intestines and cecum out of the abdominal cavity onto the lower gauze swab, folding the gauze over the organs to keep them moist.

Next, gently lift and flip the left lateral liver lobe up onto the upper gauze, and use a small pair of spring scissors to cut through the fibrous membrane on the underside of the lobe. Fold the gauze over the lobe to hold it in place.

Then, using a dissecting microscope and fine forceps, dissect the thin membrane surrounding the anterior caudate lobe and flip the lobe onto the upper gauze. Place the anterior caudate lobe under the gauze fold with the left lateral lobe, and then, dissect the posterior caudate lobe in the same way.

After placing the posterior caudate lobe under the gauze, locate the common hepatic artery by its strong pulsation. Following the artery to the anatomical right, use fine forceps to remove the thick membranous tissue obscuring the gastroduodenal and proper hepatic arteries.

Stop any bleeding with a cotton applicator. Then, use two fine atraumatic forceps to carefully dissect the common hepatic, gastroduodenal, and proper hepatic arteries from the surrounding membranes.

To inject the hepatic artery, first, pass a 7-0 prolene suture under the gastroduodenal artery, and use a microneedle holder to tie a permanent ligature at the distal end of the artery just above the bifurcation, leaving approximately 2 inches of suture material on each end.

Next, place a small clamp on the common hepatic artery to temporarily block the blood flow. Within five minutes of placing the clamp, increase the magnification until the gastroduodenal artery is in sharp focus and appears large enough to accurately insert the needle.

Then, place the injection syringe needle into the lumen of the gastroduodenal artery, and slowly depress the plunger to maximize the transduction efficiency. When the entire injection volume has been administered, slowly retract the needle from the artery, and pass a second 7-0 prolene suture beneath the gastroduodenal artery.

Tie a second permanent ligature above the injection site, and remove the clamp from the common hepatic artery. Confirm that the blood flow through the proper hepatic artery towards the liver has been restored, and cut the loose ends of the ligatures. Confirm that there is no internal bleeding. Then, return the externalized tissues to the abdominal cavity.

Using 4-0 vicryl and a curved needle, suture the muscle and skin in separate layers with continuous sutures approximately 1 millimeter apart. Then, monitor the animal until it is fully recovered.