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Case Reports
. 2022 Jan 25;5(3):145-148.
doi: 10.1002/iju5.12419. eCollection 2022 May.

Robot-assisted radical nephrectomy and inferior vena cava tumor thrombectomy: Initial experience in Japan

Daisuke Motoyama  1 , Toshiki Ito  1 , Takayuki Sugiyama  1 , Atsushi Otsuka  1 , Hideaki Miyake  1
Affiliations
Case Reports

Robot-assisted radical nephrectomy and inferior vena cava tumor thrombectomy: Initial experience in Japan

Daisuke Motoyama et al. IJU Case Rep. .

Abstract

Introduction: Open surgical approach remains the standard treatment for renal cell carcinoma with an inferior vena cava tumor thrombus. In recent years, however, robot-assisted radical nephrectomy and inferior vena cava tumor thrombectomy have emerged as minimally invasive alternatives to conventional open surgery.

Case presentation: Here, we describe a 76-year-old female patient with right renal cell carcinoma with a level I inferior vena cava thrombus undergoing robot-assisted radical nephrectomy and inferior vena cava tumor thrombectomy, which was successfully completed with a purely robotic procedure, resulting in the following outcomes: console time,167 min; total operative time, 211 min; and estimated blood loss, 150 mL. To our knowledge, this is the first case managed by robot-assisted radical nephrectomy and inferior vena cava tumor thrombectomy in Japan.

Conclusion: Based on our experience, it might be worthwhile to consider purely robotic surgery for the treatment of renal cell carcinoma with an inferior vena cava thrombus.

Keywords: inferior vena cava tumor thrombectomy; renal cell carcinoma; robot‐assisted radical nephrectomy.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Computed tomography showing right RCC with a level 1 IVC tumor thrombus (arrow). (a) Coronal section. (b) Axial section.
Fig. 2
Fig. 2
(a) The left renal vein, caudal IVC, and cephalic IVC secured by the twice‐wrapped vessel loops, and (b) sequentially clamped with the vessel loops closely by clipping in addition to the use of bulldogs. (c) The tumor thrombus (arrow) was removed from inside the IVC, after the wall of IVC was cut. (d) The IVC reconstructed with 4‐0 polypropylene suture (arrow), following the removal of the tumor thrombus.
Fig. 3
Fig. 3
(a) Macroscopic findings of the excised right renal tumor and IVC tumor thrombus (arrow) with an en bloc removal of the right adrenal gland. The excised weight was 385 g. (b) Microscopic findings of hematoxylin and eosin staining showing clear cell RCC, pT3b and Fuhrman grade 4.
See this image and copyright information in PMC

References

    1. Blute ML, Leibovich BC, Lohse CM et al. The Mayo Clinic experience with surgical management, complications and outcome for patients with renal cell carcinoma and venous tumour thrombus. BJU Int. 2004; 94: 33–41. - PubMed
    1. Murphy C, Abaza R. Complex robotic nephrectomy and inferior vena cava tumor thrombectomy: an evolving landscape. Curr. Opin. Urol. 2020; 30: 83–9. - PubMed
    1. Abaza R. Initial series of robotic radical nephrectomy with vena caval tumor thrombectomy. Eur. Urol. 2011; 59: 652–6. - PubMed
    1. Abaza R, Eun DD, Gallucci M et al. Robotic surgery for renal cell carcinoma with vena caval tumor thrombus. Eur. Urol. Focus 2016; 2: 601–7. - PubMed
    1. Ghoreifi A, Djaladat H. Surgical tips for inferior vena cava thrombectomy. Curr. Urol. Rep. 2020; 21: 51. - PubMed

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