V7-05: A Single Surgeon Experience with Robot-Assisted IVC Thrombectomy Including Synthetic Caval Patch Repair

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Introductions and Objectives
Although robot-assisted radical nephrectomy and IVC thrombectomy has been shown to be feasible, the literature is limited. We present our initial experience with robot-assisted radical nephrectomy and IVC thrombectomy that includes one case that involved a synthetic vena caval patch repair.

Methods
Six patients underwent robot-assisted radical nephrectomy and IVC thrombectomy by a single surgeon (DDE) between October 2009 and January 2012. The limit of tumor extension was level I in 3 (50.0%) patients, level II in 1 (16.7%) patient, and level III in 2 (33.3%) patients. Cavotomy was required in 5 (83.3%) patients, and 1 (16.7%) patient required a synthetic caval patch repair.

Results
Mean age of patients was 53.3 years (range 43-61), mean BMI was 25.3 kg/m2 (range 25.0-29.3). Mean IVC cross clamp time was 24.8 minutes (range 0-69), mean operative time was 192.2 minutes (range 151-257), mean estimated blood loss was 466.7 milliliters (range 200-900), and mean hospital length of stay was 6.3 days (range 5-7). On pathologic analysis, mean tumor size was 8.2 cm (range 5.8-12). There were no intraoperative or postoperative complications.

Conclusions
In appropriately selected candidates, robot-assisted radical nephrectomy with IVC thrombectomy is feasible. Vena caval reconstruction utilizing a synthetic patch may be performed using the robotic platform.

Funding: None