653 Robotic level-3 IVC thrombectomy using suprahepatic IVC control

Dr. Atanu Kumar Pal

Robotic level-3 inferior vena cava thrombectomy in the cases of locally advanced renal cell carcinoma (RCC) with level 3 retrohepatic IVC thrombus remains a significant challenge in the domain of uro-oncology. Open IVC thrombectomy is still considered as the most commonly sought after approach for this surgery. The adhesions, desmoplastic reaction, multiple feeder vessels and collaterals make the surgery critical. Along with that the optimum approach of getting adequate exposure of the IVC proximal to the thrombus and the hepatic mobilisation remain a topic of discussion. The suprahepatic clamping of the IVC is very important in complete removal of the thrombus and ensuring good outcome of the patient. We describe one such challenging case of level 3 retrohepatic IVC thrombectomy using suprahepatic IVC control. We also present the perioperative and oncological outcome of the patients who underwent level 3 IVC thrombectomy with this approach in our institute.
Procedure Innovation, Urologic Surgery, IVC thrombectomy

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