During right partial or radical nephrectomy the vena cava can be damaged. The laparoscopic approach offers great advantages for the patient with lower blood loss, pain and hospital stay, but on the other hand needs practice and a steep learning curve. Vascular accidental injury may be challenging to repair laparoscopically. In this case a small accedental opening of the vena cava was encountered during the renal pedicle isolation in a retroperitoneoscopic partial nephrectomy. The actions taken were: suction and tamponade, rising of the CO2 pressure at 20 mmHg and repair with a 3/0 monofilament. Blood loss was minimal.
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