Robot-assisted Hepatic Mobilization and Control of Suprahepatic Infradiaphragmatic Inferior Vena Cava for Level 3 Vena Caval Thrombectomy: An IDEAL Stage 0 Study

J Surg Oncol. 2015 Dec;112(7):741-5. doi: 10.1002/jso.23980. Epub 2015 Aug 11.


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.

Keywords: inferior vena cava; kidney; robotics; thrombus; tumor.

Publication types

  • Review

MeSH terms

  • Cadaver
  • Carcinoma, Renal Cell / surgery*
  • Diaphragm
  • Humans
  • Kidney Neoplasms / surgery*
  • Liver / surgery*
  • Neoplasm Invasiveness
  • Neoplastic Cells, Circulating*
  • Nephrectomy / instrumentation
  • Nephrectomy / methods*
  • Operative Time
  • Peritoneum
  • Robotic Surgical Procedures / adverse effects
  • Robotic Surgical Procedures / methods*
  • Thrombectomy / adverse effects
  • Thrombectomy / instrumentation
  • Thrombectomy / methods*
  • Vena Cava, Inferior / surgery*