Category: Robotic Surgery: UpperTract - Malignant

VS7-1 - Tips and Tricks for Robot-assisted Radical Nephrectomy and Level III Inferior Vena Cava Tumor thrombectomy

Sat, Sep 22
10:00 AM - 12:00 PM

Introduction & Objective :

In this video, we highlight surgical tips and tricks for: extensive retrohepatic IVC dissection during level 3 thrombus IVC thrombectomy, thrombus cranial margin control, and intraoperative complications management, that can occur during IVC thrombus dissection.


Methods :

In the video the following surgical tips and trips were highlighted: an extensive retrohepatic IVC dissection, with liver mobilization,essential for a wide exposure of retrohepatic IVC; the use of an occluding balloon fogarty catheter under transesophageal control, and, alternatively, ICG guidance,to better identify and control level 3 IVC tumor thrombee cranial edge;management of intraoperative complications during IVC opening and thrombus dissection.


Results :

An extensive retrohepatic IVC dissection,the use of an occluding balloon fogarty catheter under transesophageal control, and ICG guidance, represent very useful tools, to better identify and control level 3 IVC tumor thrombi cranial edge.
The management of unforeseen intraoperative complications, during IVC opening and thrombus excision, is a crucial point, during robotic IVC surgery.


Conclusions :

An extensive retrohepatic IVC dissection, with liver mobilization, is essential for a wide exposure of retrohepatic IVC.The use of an occluding balloon fogarty catheter under transesophageal control, and Near-infrared fluorescence imaging guidance, represent very useful tools, to better identify and control level 3 IVC tumor thrombi cranial edge.
The management of unforeseen intraoperative complications, during IVC opening and thrombus excision, is a crucial point, to be prepared too during robotic IVC surgery.

Gabriele Tuderti

Fellow
"Regina Elena" National Cancer Institute, Dept. of Urology
Roma, Lazio, Italy

Giuseppe Simone

Consultant
“Regina Elena” National Cancer Institute, Dept. of Urology
Roma, Lazio, Italy

Andre Luis De Castro Abreu

University of Southern California, Institute of Urology
Los Angeles, California

Sameer Chopra

University of Southern California, Institute of Urology
Los Angeles, California

Rene Sotelo

University of Southern California, Institute of Urology
Los Angeles, California

Leonardo Misuraca

Fellow
"Regina Elena" National Cancer Institute, Dept. of Urology
Rome, Lazio, Italy

Mariaconsiglia Ferriero

MD, PhD
"Regina Elena" National Cancer Institute, Dept. of Urology
Rome, Lazio, Italy

Francesco Minisola

"Regina Elena" National Cancer Institute, Dept. of Urology
Roma, Lazio, Italy

Monish Aron

University of Southern California, Institute of Urology
Los Angeles, California

Mihir M. Desai

Professor of Urology
University of Southern California
Los Angeles, California

Inderbir S. Gill

University of Southern California, Institute of Urology
Los Angeles, California

Salvatore Guaglianone

"Regina Elena" National Cancer Institute, Dept. of Urology
Roma, Lazio, Italy

Michele Gallucci

Roma, Lazio, Italy