V11-02 ROBOTIC CAVECTOMY DURING ONCOLOGICAL SURGERY: TECHNICAL CONSIDERATIONS AND OUTCOMES

Abstract

You have accessJournal of UrologyRenal Oncology II (V11)1 Sep 2021V11-02 ROBOTIC CAVECTOMY DURING ONCOLOGICAL SURGERY: TECHNICAL CONSIDERATIONS AND OUTCOMES Wesley Yip, David Ortega, Luis Medina, Alireza Ghoreifi, Nima Nassiri, Bishoy Hanna, Akbar Ashrafi, Matthew Winter, Inderbir Gill, and Hooman Djaladat Wesley YipWesley Yip More articles by this author , David OrtegaDavid Ortega More articles by this author , Luis MedinaLuis Medina More articles by this author , Alireza GhoreifiAlireza Ghoreifi More articles by this author , Nima NassiriNima Nassiri More articles by this author , Bishoy HannaBishoy Hanna More articles by this author , Akbar AshrafiAkbar Ashrafi More articles by this author , Matthew WinterMatthew Winter More articles by this author , Inderbir GillInderbir Gill More articles by this author , and Hooman DjaladatHooman Djaladat More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002073.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: An increasing proportion of renal cell carcinoma (RCC) and germ cell tumor (GCT) surgeries are being performed with a robotic-assisted laparoscopic approach. In cases of tumor and/or thrombus infiltrating the inferior vena cava (IVC) wall, adherence to the IVC endothelium, or obliteration of the IVC lumen, infra or suprarenal cavectomy may be indicated. We present our robotic cavectomy case series to demonstrate its technical feasibility and short-term outcomes. METHODS: Four patients underwent robotic cavectomy, either as adjuvant surgery (retroperitoneal lymph node dissection or radical nephrectomy) or primary procedure. Indications included: 1) post-chemotherapy retroperitoneal GCT involving the IVC, 2, 3) right-sided RCC with IVC tumor thrombus (Levels II and III), and 4) recurrent IVC tumor thrombus after previous open right radical nephrectomy and IVC thrombectomy. The post-chemotherapy retroperitoneal GCT patient underwent an infrarenal robotic cavectomy, while the RCC patients underwent suprarenal robotic cavectomies. None underwent caval reconstruction. RESULTS: All four patients tolerated intraoperative IVC clamping and subsequent cavectomy. Peri and 90-day postoperative outcomes are presented in Table 1. No patients required hemodialysis. During follow-up, there were no complications, lower extremity edema, or renal function deterioration, although the Level III IVC thrombus patient developed lung and retroperitoneal recurrences 15 months after surgery, which are planned for immunotherapy. Short-term oncological data is presented in Table 2. CONCLUSIONS: To our knowledge, this is the first case series of robotic cavectomy. We demonstrate that it can be safely performed in selected patients at experienced centers with low morbidity and complication rates. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e857-e858 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Wesley Yip More articles by this author David Ortega More articles by this author Luis Medina More articles by this author Alireza Ghoreifi More articles by this author Nima Nassiri More articles by this author Bishoy Hanna More articles by this author Akbar Ashrafi More articles by this author Matthew Winter More articles by this author Inderbir Gill More articles by this author Hooman Djaladat More articles by this author Expand All Advertisement Loading ...