Robotic inferior vena cava thrombectomy using a novel intracaval balloon occlusion technique

摘要

Robotic inferior vena cava (IVC) thrombectomy is a complex and challenging surgical operation. Optimal control of the IVC is crucial to avoid major intraoperative complications such as bleeding and embolism. Two approaches have been described for proximal control of the IVC in robotic surgery: 1. extraluminal approach by cross clamping using Rummel tourniquets or with one or more bulldog clamps or a Satinsky clamp replacing one or more of the tourniquets and 2. endoluminal approach by intracaval balloon occlusion using a Fogarty balloon catheter inserted through a cavotomy. Herein, we describe another endoluminal method using a Reliant stent graft balloon catheter (SGBC) inserted through endovascular access through the right internal jugular vein (IJV) under fluoroscopy and placed above the tumor thrombus.