Volume 47, Issue 3, Pages 352-356 (March 2005) Retroperitoneal Laparoscopic Radical Nephrectomy for Renal Cell Carcinoma with Infrahepatic Vena Caval Thrombus  Vincenzo Disanto, Vito Pansadoro, Filippo Portoghese, Gino Alessandro Scalese, Michele Romano  European Urology  Volume 47, Issue 3, Pages 352-356 (March 2005) DOI: 10.1016/j.eururo.2004.11.010 Copyright © 2004 Elsevier B.V. Terms and Conditions

Fig. 1 CT-scan shows an enlarged non-functioning right kidney (15×5cm) with a large heterologous mass in the mid-upper third measuring 7cm, invading the excretory pathways. An endoluminal thrombus is present in the renal vein extending in vena cava for 7cm. European Urology 2005 47, 352-356DOI: (10.1016/j.eururo.2004.11.010) Copyright © 2004 Elsevier B.V. Terms and Conditions

Fig. 2 Patient in lateral position. Four trocars are positioned as a rhomb: (1) Hasson trocar is positioned along the elongation of the 12th rib, (2) trocar on the posterior axillary line, (3) trocar above iliac crest, (4) trocar on the anterior axillary line. European Urology 2005 47, 352-356DOI: (10.1016/j.eururo.2004.11.010) Copyright © 2004 Elsevier B.V. Terms and Conditions

Fig. 3 Intraoperative image. Endoluminal thrombus is present in the renal vein extending in vena cava for 7cm. European Urology 2005 47, 352-356DOI: (10.1016/j.eururo.2004.11.010) Copyright © 2004 Elsevier B.V. Terms and Conditions

Fig. 4 Intraoperative image. The vena cava is opened; the large thrombus appears. European Urology 2005 47, 352-356DOI: (10.1016/j.eururo.2004.11.010) Copyright © 2004 Elsevier B.V. Terms and Conditions

Fig. 5 Operating specimen including the right kidney, the perirenal fatty tissue and the thrombus. European Urology 2005 47, 352-356DOI: (10.1016/j.eururo.2004.11.010) Copyright © 2004 Elsevier B.V. Terms and Conditions