V13-03 EIGHT-YR EXPERIENCE OF ROBOTIC IVC THROMBECTOMY: SURGICAL TECHNIQUE, PERIOPERATIVE AND ONCOLOGIC OUTCOMES

Abstract

You have accessJournal of UrologyCME1 May 2022V13-03 EIGHT-YR EXPERIENCE OF ROBOTIC IVC THROMBECTOMY: SURGICAL TECHNIQUE, PERIOPERATIVE AND ONCOLOGIC OUTCOMES Leonardo Misuraca, Umberto Anceschi, Gabriele Tuderti, Riccardo Mastroianni, Mariaconsiglia Ferriero, Aldo Brassetti, Alfredo Maria Bove, Salvatore Guaglianone, Mihir Desai, Inderbir Singh Gill, Michele Gallucci, and Giuseppe Simone Leonardo MisuracaLeonardo Misuraca More articles by this author , Umberto AnceschiUmberto Anceschi More articles by this author , Gabriele TudertiGabriele Tuderti More articles by this author , Riccardo MastroianniRiccardo Mastroianni More articles by this author , Mariaconsiglia FerrieroMariaconsiglia Ferriero More articles by this author , Aldo BrassettiAldo Brassetti More articles by this author , Alfredo Maria BoveAlfredo Maria Bove More articles by this author , Salvatore GuaglianoneSalvatore Guaglianone More articles by this author , Mihir DesaiMihir Desai More articles by this author , Inderbir Singh GillInderbir Singh Gill More articles by this author , Michele GallucciMichele Gallucci More articles by this author , and Giuseppe SimoneGiuseppe Simone More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002646.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: First robotic nephrectomy with IVC thrombectomy was performed in 2008, while the rst series was reported in 2011. Since then, several surgeons at various institutions have adopted robotic surgery for these complex procedures. Safety, feasibility and short-term outcomes of robotic radical nephrectomy and inferior vena cava thrombectomy for level 2 and level 3 IVC thrombi has been reported. In this video, we illustrate key surgical steps to manage level 2 and 3 ICV thrombi and we report outcomes of our cumulative experience started in 2014. METHODS: The video reports surgical steps as follows: IVC isolation, cranial thrombus edge control, tumor thrombectomy, cavoscopy, cava suture, IVC ow restoration control. Tips and tricks were illustrated, including the use of intracaval balloon, transesophageal ultrasound control, near infrared uorescence imaging to manage thrombus edge and to ensure proper restoration of IVC ow. Perioperative and oncologic outcomes were reported. RESULTS: Our series comprises 37 patients, 18 of which with level 3 thrombi. Median operative time was 360 minutes. Perioperative complications occurred in around 50% of patients, with only 4 cases of Clavien Grade complication ≥ 3. Median follow up time was 29 months. 3-yr overall survival, cancer specic survival and metastasis free survival was 54.7%, 55.7% and 22%, respectively. CONCLUSIONS: Robotic IVC thrombectomy is a feasible and safe procedure, even for level 2 and 3 thrombi. Surgical technique is skill demanding and should be not performed outside tertiary referral centers. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e1031 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Leonardo Misuraca More articles by this author Umberto Anceschi More articles by this author Gabriele Tuderti More articles by this author Riccardo Mastroianni More articles by this author Mariaconsiglia Ferriero More articles by this author Aldo Brassetti More articles by this author Alfredo Maria Bove More articles by this author Salvatore Guaglianone More articles by this author Mihir Desai More articles by this author Inderbir Singh Gill More articles by this author Michele Gallucci More articles by this author Giuseppe Simone More articles by this author Expand All Advertisement PDF DownloadLoading ...