Robot-assisted radical nephrectomy with inferior vena cava XXXX thrombectomy: technique and initial outcomes.

@entity1 @entity5 @entity190 @entity7502 @entity260 @entity37694
INTRODUCTION: To describe our technique for robot-assisted radical nephrectomy (RARN) with inferior vena cava (IVC) @entity5 thrombectomy and to present initial results for our first two @entity1 . MATERIALS AND METHODS: Two @entity1 with renal masses with infrahepatic IVC extension underwent RARN with IVC @entity5 thrombectomy using a four-arm configuration. Both cases were right-sided @entity5 . Vascular control was obtained with complete cross-clamping of the vena cava with robotic bulldog clamps. Intraoperative ultrasound was used to delineate extent of @entity5 extension. Specimens were removed en-bloc, and the IVC was closed with 2-layers of 4-0 @entity7502 . The specimen is extracted through a lower midline incision. RESULTS: Two robotic IVC thrombectomies were successfully completed. There were no conversions, @entity260 . Median operative time was 243 minutes with a median estimated @entity190 of 150 mL. Both @entity1 were able to ambulate independently free of intravenous opioids on postoperate day 1. Median length of stay was 4.5 (range 3-6) days. Final pathology revealed @entity37694 in both cases with negative surgical margins. CONCLUSIONS: Robotic technology may facilitate RN and IVC thrombectomy in the well selected @entity1 and appears to be a safe and feasible approach.
