BACKGROUND: Renal or adrenal neoplastic vein thrombi are relative contra-indications for laparoscopic treatment.
To the best of our knowledge, we present the first robot-assisted radical adrenalectomy (RARA) with the presence of a thrombus in the adrenal vein.
METHODS: A 54 year-old male with a history of laparoscopic left radical nephrectomy for clear cell carcinoma was referred to our department with a diagnosed right adrenal tumour extending into the adrenal vein. A RARA was planned through a trans-peritoneal approach, and an en bloc resection of the adrenal and its vein with clamping of the vena cava was performed.
RESULTS: Console time was 94 min and the estimated blood loss was 44 ml. The pathology report confirmed clear cell carcinoma with negative surgical margins. Convalescence was uneventful.
CONCLUSION: RARA with thrombectomy and vascular reconstruction can be safe, effective and feasible in experienced hands, using robotic bulldogs.
Written by:
Ploumidis A, Spinoit AF, De Naeyer G, Ficarra V, Mottrie A. Are you the author?
Department of Urology, OLV Vattikuti Robotic Surgery Institute, Aalst, Belgium.
Reference: Int J Med Robot. 2015 Mar 1. Epub ahead of print.
doi: 10.1002/rcs.1641
PubMed Abstract
PMID: 25727563