Department of Urology, Affiliated Beijing Chaoyang Hospital of Capital
Medical University, Beijing 100020, China
Introduction: To evaluate the feasibility of pure laparoscopic
radical nephrectomy with level II inferior vena caval
Methods: One patient was performed pure laparoscopic
left radical nephrectomy with level II inferior vena caval
thrombectomy. Five trocars were placed during operation. Left
renal artery was controlled by Hem-o-lok clips and dissected
by Ligasure. The inferior vena cava and right renal vein were
isolated and temporarily clamped. The left renal vein was incised
circumferentially at its junction with the inferior vena cava, and
the tumor thrombus was extracted entirely.
Results: The operation was performed successfully. The
operative time was 400 min, the estimated blood loss was
1800 mL and the patient was administered a 2000 mL. blood
transfusion during operation. No intraoperative or postoperative
complications occurred and the patient was discharged on
postoperative day 10. The pathology revealed renal clear cell
carcinoma, 90% of the tumor was grade II, and 10% was grade
III. The length of the tumor thrombus was approximately 8 cm.
Conclusions: Pure laparoscopic radical nephrectomy with level
II inferior vena caval thrombectomy is technically demanding
procedure. However, it is feasible in carefully selected patients
and experienced surgeon.