Robot‐assisted radical nephrectomy and inferior vena cava tumor thrombectomy using the novel surgical robot platform, hinotori: Initial experience with two cases

Figures

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  Fig. 1. (a–e) Case 1 showing right RCC with a level II IVC tumor thrombus (arrow). (a) Axial section of computed tomography (CT). (b) Coronal section of CT. (c) Three‐dimensional reconstructed image from CT. (d), Macroscopic findings of the excised right kidney and IVC tumor thrombus (arrow). Excised weight was 595 g. (e) Microscopic findings of hematoxylin and eosin staining showing clear cell RCC, pT3b, WHO/ISUP grade 3. (f–j) Case 2 showing right RCC with level I IVC tumor thrombus (arrow). (f) Axial section of CT. (g) Coronal section of CT. (h) Three‐dimensional reconstructed image from CT. (i), Macroscopic findings of the excised right kidney and IVC tumor thrombus (arrow). Excised weight was 635 g. (j), Microscopic findings of hematoxylin and eosin staining showing clear cell RCC, pT3b, WHO/ISUP grade 4.

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  Fig. 2. Intraoperative images during robot‐assisted RN and IVC tumor thrombectomy for case 2 who had level I IVC tumor thrombus. (a) The left renal vein, caudal IVC, and cephalic IVC are secured by twice‐wrapped vessel loops, and (b) sequentially clamped with the vessel loops by clipping in addition to the use of bulldogs. (c) Tumor thrombus (arrow) is removed from the IVC, and the wall of IVC is cut. (d) The IVC is reconstructed by continuous suture with a 4‐0 polypropylene (arrow), following removal of the tumor thrombus.