Robot-assisted hepatic mobilization and control of suprahepatic infradiaphragmatic inferior vena cava for level 3 vena caval thrombectomy: An IDEAL stage 0 study.
Robot-assisted level 1/2 inferior vena caval (IVC) thrombectomy techniques have been recently described for clinical use. Following the IDEAL recommendations on safe surgical innovation, we here describe a robotic approach for level 3 IVC thrombectomy in fresh frozen cadavers (IDEAL stage 0). In all cadavers (n = 3), hepatic mobilization with control of short hepatic veins, contralateral renal vein, infrarenal IVC and suprahepatic-infradiaphragmatic IVC could be achieved successfully, without converting to open surgery. Clinical feasibility of our technique remains to be tested.
Vattikuti Urology Institute, Henry Ford Health System, Detroit, Michigan.
Akshay
A
Sood
Vattikuti Urology Institute, Henry Ford Health System, Detroit, Michigan.
Wooju
W
Jeong
Vattikuti Urology Institute, Henry Ford Health System, Detroit, Michigan.
Ravi
R
Barod
Department of Urology, University of Cincinnati, Cincinnati, Ohio.
Eamonn
E
Bahnson
Department of Urology, Ohio State University, Columbus, Ohio.
Parfait
P
Kirura
Vattikuti Urology Institute, Henry Ford Health System, Detroit, Michigan.
Firas
F
Abdollah
Vattikuti Urology Institute, Henry Ford Health System, Detroit, Michigan.
Mahendra
M
Bhandari
Department of Urology, Ohio State University, Columbus, Ohio.
Robert
R
Bahnson
Vattikuti Urology Institute, Henry Ford Health System, Detroit, Michigan.
Mani
M
Menon
D002102:Cadaver; D002292:Carcinoma, Renal Cell / Q000601:surgery*; D003964:Diaphragm; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D008099:Liver / Q000601:surgery*; D009361:Neoplasm Invasiveness; D009360:Neoplastic Cells, Circulating; D009392:Nephrectomy / Q000295:instrumentation / Q000379:methods*; D061646:Operative Time; D010537:Peritoneum; D065287:Robotic Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D017131:Thrombectomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D014682:Vena Cava, Inferior / Q000601:surgery*
inferior vena cava; kidney; robotics; thrombus; tumor