Robotic surgery for inferior vena cava thrombectomy

Rocco Papalia1, Giuseppe Simone2, Mariaconsiglia Ferriero3, Riccardo Mastroianni3, Salvatore Guaglianone3, Giovanni Muto4, Michele Gallucci3
  • 1 Università Campus Biomedico, Istituto Nazionale Tumori "Regina Elena" (Roma)
  • 2 Istituto Nazionale Tumori "Regina Elena", Ospedale San Giovanni Bosco (Roma, Torino)
  • 3 Istituto Nazionale Tumori "Regina Elena" (Roma)
  • 4 Università Campus Biomedico (Roma)


INTRODUCTION AND OBJECTIVES: Robotic surgery as been applied to increasingly complex urologic procedures. Surgery of renal tumors involving the inferior vena cava (IVC) was usually performed by an open approach. At selected institutions, the advantages of robotic surgery for IVC thrombectomy is under investigation. We present here a case of robotic IVC thrombectomy.
METHODS: The video shows the robotic approach of IVC thrombectomy in a 82 years old man with right kidney cancer extended to the vena cava.
RESULTS: Thrombectomy time was 160 min, IVC clamp time was 55 min and nephrectomy time was 110 min. Thrombus Size was 3 cm. Estimated blood loss was 800 cc. No transfusions were necessary. POD1 Haemoglobin was 12.7 and sCreatinine 1.88. Patient was discharged 3 days after surgery.
CONCLUSIONS: At selected institutions robotic surgery for level I and II caval thrombi is feasible. With experience and standardized surgical techinique, the procedure can be reproduced in selected institutions and properly selected cases. Further multy-institutional experiences are necessary to validate this relatively new challenging procedure.

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