Laparoscopic Radical Nephrectomy for T3B Tumor

Abstract

With the advancement of laparoscopic equipment and growing operational experience, the number of case reports or descriptions of series of nephrectomies performed in patients with the preoperative diagnosis of venous system involvement has become more frequent in the medical literature. In this article, we present the case of a laparoscopic nephrectomy performed with retroperitoneoscopic access for preoperatively diagnosed renal vein and vena cava thrombus. Operation time was 130 minutes and blood loss was 50 mL. The weight of the specimen was 460 g. The postoperative course was uncomplicated. The pathology report revealed pT3b clear cell cancer (Fuhrman grade 2) with negative margins on the venous cutting line.

Pure retroperitoneal laparoscopic radical nephrectomy and thrombectomy with delayed occlusion of the proximal inferior vena cava (DOPI) technique for renal tumor with level II-III venous tumor thrombus

“…Both retroperitoneal and transperitoneal approaches have been reported to be used in LRN and thrombectomy [14][15][16][17]; thus, it is the preference of surgeon that decides the selection of surgical approach. In our centre, we performed LRN and thrombectomy using the retroperitoneal approach, because we have extensive experience in retroperitoneal laparoscopic surgery.…”

Laparoscopic radical nephrectomy for large renal tumor – a case report and technical considerations

“…Although there are articles in the literature presenting laparoscopic nephrectomy in patients with vena cava involvement, in such cases the authors perform open procedures [11]. …”

Operative Techniques and Outcomes in Laparoscopic Radical Nephrectomy

“…Aggressive surgical management with complete resection of tumor thrombus is the only treatment option that offers the potential for cure in these patients which is a technically and physically demanding procedure, and has traditionally been performed open surgically with significant associated risks of perioperative morbidity and mortality [1]. LRN has been used predominantly for level I-II thrombi [26][27][28][29][30][31][32][33]. The procedure is technically demanding even in the hands of experienced laparoscopic surgeons in view of rigid instrumentation, restricted movements, transmitted physiological tremor, prolonged learning curve and more specifically difficulty in suture repair of the IVC and controlling major intra-abdominal bleeding [1].…”