To describe a case of robotic inferior vena cava resection for an advanced case of renal cell carcinoma with accompanying robotic caval replacement using a synthetic graft.
In this report and accompanying video we describe a case of complete caval reconstruction with 3 year follow up. A 49-year-old male who at the age of 40 (9 years ago) had undergone right open partial nephrectomy for a pT1b 4.6 cm Fuhrman Grade 2 clear cell RCC with negative margins was found to have a recurrent mass at 6 years of follow up with suspicion of invasion into duodenum and IVC. For his recurrence, he underwent robotic assisted laparoscopic right radical nephrectomy and IVC resection followed by a placement of a 18mm GORE-TEX® graft anastomosed to the caudal and cephalad edges of the resected cava.
The surgery was successfully completed using robotic assistance with a total operative time of 6 hours and 40 minutes and 900cc blood loss. The patient experienced no intraoperative or perioperative complications and was discharged home on postoperative day #2. At 3 year of follow up there is no evidence of local recurrence. The radiology reports repeatedly commented on vascular structures "within normal limits". The patient had experienced no graft issues at a present follow up.
This case provides a description of the surgery with video demonstration of technique as well as provides a few technical suggestions that may be useful for those who attempt similar surgery in the future.
Urology. 2021 Dec 08 [Epub ahead of print]
Kathryn Scott, Jared Manwaring, Kwame Amankwah, Gennady Bratslavsky
SUNY Upstate Medical Center, 750 East Adams Street, Syracuse, NY 13210., SUNY Upstate Medical Center, 750 East Adams Street, Syracuse, NY 13210. Electronic address: .