Laparoscopic right nephrectomy and inferior vena cava thrombectomy with both retro and trans-peritoneal approch
Renal cell carcinoma with inferior vena cava (IVC) thrombus indicates biologically aggressive cancer, so the complete surgical resection remains standard of care with best long term outcomes. In this video we describe laparoscopic right nephrectomy and with thrombectomy by both retro and trans-peritoneal approach.
Patient is a 56 year old man with incidental diagnosis of a right renal mass (30 cm) with 2nd type of vena cava thrombus (6 cm).
The video shows our procedure: laparoscopic radical nephrectomy and inferior vena cava thrombectomy by both retro and trans-peritoneal approach.
Operative time was 320 minutes; blood loss 470 ml; IVC occlusion time 13 minutes; hospital stay 5 days.
Operative outcomes show that laparoscopic radical nephrectomy with inferior vena cava thrombectomy is safe and feasible also for level 2 tumor thrombus.
We chosed to perform retro and trans-peritoneal approach considering clinical case and necessity of better, complete and safe vascular control.