A Case Series of Six Patients With Renal Cell Carcinoma With Inferior Vena Cava Tumor Thrombus Who Underwent Robotic‐Assisted Radical Nephrectomy

INTRODUCTION: Inferior vena cava (IVC) tumor thrombus occurs in 4%-10% of renal cell carcinoma (RCC) cases. Robotic-assisted radical nephrectomy (RARN) with IVC tumor thrombectomy offers a minimally invasive alternative to open surgery. MATERIALS AND METHODS: We retrospectively reviewed six cases of RARN for RCC with IVC thrombus at two institutions between April 2022 and August 2024. For left-sided RCC, the left renal vein was transected using a vascular stapler before IVC thrombectomy, ensuring adequate access for thrombus removal. RESULTS: Four patients had right-sided RCC, and two had left-sided RCC. The median operative time was 256 min, with a median blood loss of 175 mL. No conversions to open surgery, positive surgical margins, or major complications (Clavien-Dindo grade ≥ 3) were reported. No blood transfusions were required. CONCLUSION: RARN with IVC thrombectomy resulted in minimal blood loss and no serious complications. Our findings suggest that it is a feasible and safe procedure, even when performed with technical modifications for left-sided RCC.