Abstract: Intraoperative bleeding from the inferior vena cava and/or the post hepatic vena cava that cannot be controlled can result in the patient's death. The ‘P.A. (peritoneal-atrial) Link Off System’ is a new surgical device that allows the surgeon to control bleeding from the inferior vena cava and/or the post hepatic vena cava. The ‘P.A. Link Off System’ is comprised of a new plastic tube ‘shunt’ and a new vascular clamp. A 26 cm clear plastic tube with three inflatable cuffs at different lengths along the tube. This is inserted into the inferior vena cava, below the renal veins. Once the cuffs are inflated, a vascular clamp, that allows closure of the inferior vena cava without closing the lumens of the 5 tubes, is placed. This allows control and isolation of the post hepatic vena cava.