Teaching residents to operate impute responsibility. We aim not only to make them accomplish curriculum, nor being solely capable of executing the procedure properly but mainly to endow them with skills that allow them to face complications with confidence. "Cava daí para fora" is a popular Portuguese saying which means "run out of there" and we use it always when helping residents facing inferior vena cava (IVC) during right adrenal surgery. Despite its importance, the authors found very few references concerning IVC laceration during laparoscopic adrenalectomy. Is this a rare complication or surgeons do not report it? We review our institution experience on solving iatrogenic IVC lacerations during adrenal surgery and discuss operative strategies.

Review of casuistry of a single Institution on its first year as Eurocrine member and video presentation on "how I do it"

Operative strategies historically have evolved to include today's traditional vascular surgical techniques such as lateral venorrhaphy, patch, ligation, patch cavoplasty, or shunts. Laparoscopic adequate exposure of the IVC can be challenging and is dictated by the location of the injury. The authors analyze their own one-year database and report their experience with video iconography. Lastly, the authors share tips and tricks.

Major vascular complications following laparoscopic procedures are rare, with less than 30 cases reported in the literature and only few related to adrenalectomy. The IVC is the most frequently injured major vein and its repair can be challenging. The endocrine surgeon must be able to face and solve it so he doesn't need to "cavar daí para fora".