V04-02 Re-Do Robot-Assisted Vena Cava Thrombectomy: Feasibility and Results

You have accessJournal of UrologyAdrenal/Renal Oncology I (V04)1 May 2024V04-02 RE-DO ROBOT-ASSISTED VENA CAVA THROMBECTOMY: FEASIBILITY AND RESULTS Gaëlle Margue, Abderrahmane Khaddad, François Luyckx, Clément Allenet, Mokrane Yacoub, Vincent Estrade, Eric Alezra, Grégoire Capon, Franck Bladou, Grégoire Robert, Marine Gross-Goupil, and Jean-Christophe Bernhard Gaëlle MargueGaëlle Margue , Abderrahmane KhaddadAbderrahmane Khaddad , François LuyckxFrançois Luyckx , Clément AllenetClément Allenet , Mokrane YacoubMokrane Yacoub , Vincent EstradeVincent Estrade , Eric AlezraEric Alezra , Grégoire CaponGrégoire Capon , Franck BladouFranck Bladou , Grégoire RobertGrégoire Robert , Marine Gross-GoupilMarine Gross-Goupil , and Jean-Christophe BernhardJean-Christophe Bernhard View All Author Informationhttps://doi.org/10.1097/01.JU.0001009444.59519.d3.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The aim was to present the surgical management of vena cava carcinomatous thrombus recurrence using a robot-assisted laparoscopic approach. METHODS: The surgery was performed using the Da-Vinci Xi surgical robot (Intuitive surgical). We used 3 operative arms, a 30° optic and 2 trocars (5 and 12 mm) for the assistant. Thrombus extension was assessed using an intraoperative ultrasound (Hitachi). RESULTS: Our patient was a 59-year-old man in good general condition, who underwent a right radical nephrectomy with vena cava thrombectomy using a subcostal incision in November 2021 for a clear cell renal cell carcinoma, Fuhrman 4, pT3b, N0 R0. A local recurrence of an isolated suspended vena cava thrombus was detected on a follow-up scan in August 2022. The PET scan showed hypermetabolism of the thrombus and surgical management of this recurrence was validated. A robot-assisted vena cava thrombectomy was performed. Surgery lasted 4 hours and 20 minutes, with 16 minutes of vena cava clamping and an estimated blood loss of 300 cc. The postoperative course was uncomplicated. Pathological analysis confirmed a clear cell renal cell carcinoma, Fürhman 3, invading the venous wall, with negative margins. CONCLUSIONS: In the case of vena cava carcinomatous thrombus recurrence, minimally invasive salvage surgery is feasible with low morbidity in selected patients. It should be considered as an alternative to systemic treatment, thereby allowing therapeutic savings. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e196 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Gaëlle Margue More articles by this author Abderrahmane Khaddad More articles by this author François Luyckx More articles by this author Clément Allenet More articles by this author Mokrane Yacoub More articles by this author Vincent Estrade More articles by this author Eric Alezra More articles by this author Grégoire Capon More articles by this author Franck Bladou More articles by this author Grégoire Robert More articles by this author Marine Gross-Goupil More articles by this author Jean-Christophe Bernhard More articles by this author Expand All Advertisement PDF downloadLoading ...