Robot Assisted Right Radical Nephrectomy With Level II Inferior Vena Cava Tumor Thrombectomy

The video demonstration of robotic radical nephrectomy with inferior vena caval (IVC) thrombectomy and retroperitoneal lymph-node dissection for right-sided renal cell carcinoma with level II IVC thrombus.

79 year old man presented with 11.2 cm right renal mass completely replacing the kidney along with renal vein thrombus extending into IVC. Patient underwent angio-embolisation on day of surgery. Procedure was done with Da Vinci Xi robot, standard 6 port transperitoneal approach in left lateral position. Steps followed are 1)entering retroperitoneum 2)hilar dissection and exposure of IVC 3)control of IVC and left renal vein 4)IVC cavotomy, thrombectomy, reconstruction 5)control of renal vessels 6)nephrectomy and lymph node dissection. Intraoperative and immediate post-operative outcomes are noted.

Vattikuti Fellow Dr. Preetham Dev, studying under Dr. T. B. Yuvaraja, KDAH, Mumbai.