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Volume 69, Issue 6, Pages (June 2016)

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Presentation on theme: "Volume 69, Issue 6, Pages (June 2016)"— Presentation transcript:

1 Volume 69, Issue 6, Pages 1112-1119 (June 2016)
Robot-assisted Laparoscopic Inferior Vena Cava Thrombectomy: Different Sides Require Different Techniques  Baojun Wang, Hongzhao Li, Xin Ma, Xu Zhang, Liangyou Gu, Xintao Li, Yang Fan, Yu Gao, Kan Liu, Jie Zhu  European Urology  Volume 69, Issue 6, Pages (June 2016) DOI: /j.eururo Copyright © 2015 European Association of Urology Terms and Conditions

2 Fig. 1 Port placement and docking for robot-assisted laparoscopic inferior vena cava thrombectomy. (A and B) Point C: the 12-mm port for the robot camera, at about 2–3cm to the upper right of the umbilicus. Point 1: the 8-mm port for the first robot arm, at about 3cm medial to the right midclavicular line under the costal margin. Point 2: the 8-mm port for the second robot arm, about 3cm lateral to the right midclavicular line near McBurney's point. Point 3: the 8-mm port for the third robot arm, at 6–8cm lateral to the second robot arm. Point A1: the 12-mm port for the aspirator, about 6cm above the umbilical; point A2: the 12-mm port for Hem-o-lok clips, near the umbilical. Point A3: the 5-mm port for the retraction of the liver, near the xiphoid under the costal margin. (B) The camera arm and the first, second, and third robot arms were docked with ports, which were placed at points C, 1, 2, and 3, respectively. European Urology  , DOI: ( /j.eururo ) Copyright © 2015 European Association of Urology Terms and Conditions

3 Fig. 2 The exposure of the inferior vena cava and its tributaries. (A) The ventral surface of the inferior vena cava was exposed and (B) the ventral surfaces of the right renal vein and the left renal vein were isolated. (C) The accessory hepatic vein was clipped with a Hem-o-lok and (D) the lumbar vein was clipped with a Hem-o-lok. European Urology  , DOI: ( /j.eururo ) Copyright © 2015 European Association of Urology Terms and Conditions

4 Fig. 3 Sketch map for clamping vessels in order for right renal cell carcinoma involving inferior vena cava thrombus. The caudal inferior vena cava was clamped with the vessel loop. The left renal vein was clamped with the vessel loop. The cephalic inferior vena cava was clamped with the vessel loop. European Urology  , DOI: ( /j.eururo ) Copyright © 2015 European Association of Urology Terms and Conditions

5 Fig. 4 Inferior vena cava thrombectomy. (A) The caudal inferior vena cava (IVC), left renal vein, and cephalic IVC were clamped. (B) The IVC wall was incised, and the IVC thrombus was exposed. (C) The IVC thrombus was delivered intact from the IVC lumen. (D) The IVC was closed by a running suture. European Urology  , DOI: ( /j.eururo ) Copyright © 2015 European Association of Urology Terms and Conditions

6 Fig. 5 Ligating and disconnecting the left renal vein, which included the thrombus, with Endo-GIA. (A) Before ligating and disconnecting and (B) after ligating and disconnecting. European Urology  , DOI: ( /j.eururo ) Copyright © 2015 European Association of Urology Terms and Conditions

7 Fig. 6 Sketch map for clamping vessels in order for left renal cell carcinoma involving an inferior vena cava thrombus. The caudal inferior vena cava was clamped with the vessel loop. The right renal artery was clamped with the vessel loop (or with a bull-dog clamp). The right renal vein was clamped with the vessel loop (or with a bull-dog clamp). The cephalic inferior vena cava was clamped with the vessel loop. European Urology  , DOI: ( /j.eururo ) Copyright © 2015 European Association of Urology Terms and Conditions


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