Robot Assisted Surgery of the Vena Cava: Perioperative Outcomes, Technique, and Lessons Learned at The Mayo Clinic

Kyle M. Rose, Anojan K. Navaratnam, Haidar M. Abdul-Muhsin, Kassem S. Faraj, Sarah A. Eversman, Adyr A. Moss, William G. Eversman, William M. Stone, Samuel R. Money, Victor J. Davila, Erik P. Castle

Research output: Contribution to journalArticle

Abstract

Introduction: This study aims to describe robot assisted surgery of the inferior vena cava (IVC) by assessing techniques utilized, perioperative outcomes, complications, and long-term patency of the IVC. Methods: A retrospective review was performed on all robotic surgeries involving dissection and repair of the IVC at our institution. Patient characteristics, operative reports, and follow-up visits were analyzed. Preoperative and postoperative imaging was independently reviewed by a single radiologist to determine changes in IVC diameter. Complications were analyzed according to early (<30 days) vs late (>30 days). Results: Thirty-four patients underwent robot assisted surgery of the vena cava from 2008 to 2018. Twenty-six cases were performed for urologic malignancy, four were performed for IVC filter explantation, and four renal vein transpositions were performed for nutcracker syndrome. Twenty-four of the 26 patients with urologic malignancy underwent radical nephrectomy with IVC tumor thrombectomy. Three cases were converted to open. Median length of stay was two nights, and mean estimated blood loss (EBL) was 375 mL. There were five complications, ranging from Clavien-Dindo grade II-IIIa, four of which were early complications. No patients required return to the operating room, and there were no perioperative mortalities. IVC diameter was reduced by 41% on axial diameter, with no patients experiencing compromised venous return. Conclusion: Robot assisted surgery offers the advantage of minimally invasive surgery with the ability to apply open surgical principles. In our series, an experienced multidisciplinary team approach yielded low EBL, short length of stay, and low complication rates.

Original languageEnglish (US)
Pages (from-to)1009-1016
Number of pages8
JournalJournal of endourology
Volume33
Issue number12
DOIs
StatePublished - Dec 1 2019

Fingerprint

Venae Cavae
Inferior Vena Cava
Length of Stay
Vena Cava Filters
Neoplasms
Thrombectomy
Renal Veins
Minimally Invasive Surgical Procedures
Robotics
Operating Rooms
Nephrectomy
Dissection
Mortality

Keywords

  • inferior vena cava filter
  • nutcracker syndrome
  • robot assisted
  • tumor thrombus
  • vena cava

ASJC Scopus subject areas

  • Urology

Cite this

Robot Assisted Surgery of the Vena Cava : Perioperative Outcomes, Technique, and Lessons Learned at The Mayo Clinic. / Rose, Kyle M.; Navaratnam, Anojan K.; Abdul-Muhsin, Haidar M.; Faraj, Kassem S.; Eversman, Sarah A.; Moss, Adyr A.; Eversman, William G.; Stone, William M.; Money, Samuel R.; Davila, Victor J.; Castle, Erik P.

In: Journal of endourology, Vol. 33, No. 12, 01.12.2019, p. 1009-1016.

Research output: Contribution to journalArticle

Rose, KM, Navaratnam, AK, Abdul-Muhsin, HM, Faraj, KS, Eversman, SA, Moss, AA, Eversman, WG, Stone, WM, Money, SR, Davila, VJ & Castle, EP 2019, 'Robot Assisted Surgery of the Vena Cava: Perioperative Outcomes, Technique, and Lessons Learned at The Mayo Clinic', Journal of endourology, vol. 33, no. 12, pp. 1009-1016. https://doi.org/10.1089/end.2019.0429
Rose, Kyle M. ; Navaratnam, Anojan K. ; Abdul-Muhsin, Haidar M. ; Faraj, Kassem S. ; Eversman, Sarah A. ; Moss, Adyr A. ; Eversman, William G. ; Stone, William M. ; Money, Samuel R. ; Davila, Victor J. ; Castle, Erik P. / Robot Assisted Surgery of the Vena Cava : Perioperative Outcomes, Technique, and Lessons Learned at The Mayo Clinic. In: Journal of endourology. 2019 ; Vol. 33, No. 12. pp. 1009-1016.
@article{5ea619ad5c1146209b37585fec7d70b7,
title = "Robot Assisted Surgery of the Vena Cava: Perioperative Outcomes, Technique, and Lessons Learned at The Mayo Clinic",
abstract = "Introduction: This study aims to describe robot assisted surgery of the inferior vena cava (IVC) by assessing techniques utilized, perioperative outcomes, complications, and long-term patency of the IVC. Methods: A retrospective review was performed on all robotic surgeries involving dissection and repair of the IVC at our institution. Patient characteristics, operative reports, and follow-up visits were analyzed. Preoperative and postoperative imaging was independently reviewed by a single radiologist to determine changes in IVC diameter. Complications were analyzed according to early (<30 days) vs late (>30 days). Results: Thirty-four patients underwent robot assisted surgery of the vena cava from 2008 to 2018. Twenty-six cases were performed for urologic malignancy, four were performed for IVC filter explantation, and four renal vein transpositions were performed for nutcracker syndrome. Twenty-four of the 26 patients with urologic malignancy underwent radical nephrectomy with IVC tumor thrombectomy. Three cases were converted to open. Median length of stay was two nights, and mean estimated blood loss (EBL) was 375 mL. There were five complications, ranging from Clavien-Dindo grade II-IIIa, four of which were early complications. No patients required return to the operating room, and there were no perioperative mortalities. IVC diameter was reduced by 41{\%} on axial diameter, with no patients experiencing compromised venous return. Conclusion: Robot assisted surgery offers the advantage of minimally invasive surgery with the ability to apply open surgical principles. In our series, an experienced multidisciplinary team approach yielded low EBL, short length of stay, and low complication rates.",
keywords = "inferior vena cava filter, nutcracker syndrome, robot assisted, tumor thrombus, vena cava",
author = "Rose, {Kyle M.} and Navaratnam, {Anojan K.} and Abdul-Muhsin, {Haidar M.} and Faraj, {Kassem S.} and Eversman, {Sarah A.} and Moss, {Adyr A.} and Eversman, {William G.} and Stone, {William M.} and Money, {Samuel R.} and Davila, {Victor J.} and Castle, {Erik P.}",
year = "2019",
month = "12",
day = "1",
doi = "10.1089/end.2019.0429",
language = "English (US)",
volume = "33",
pages = "1009--1016",
journal = "Journal of Endourology",
issn = "0892-7790",
publisher = "Mary Ann Liebert Inc.",
number = "12",

}

TY - JOUR

T1 - Robot Assisted Surgery of the Vena Cava

T2 - Perioperative Outcomes, Technique, and Lessons Learned at The Mayo Clinic

AU - Rose, Kyle M.

AU - Navaratnam, Anojan K.

AU - Abdul-Muhsin, Haidar M.

AU - Faraj, Kassem S.

AU - Eversman, Sarah A.

AU - Moss, Adyr A.

AU - Eversman, William G.

AU - Stone, William M.

AU - Money, Samuel R.

AU - Davila, Victor J.

AU - Castle, Erik P.

PY - 2019/12/1

Y1 - 2019/12/1

N2 - Introduction: This study aims to describe robot assisted surgery of the inferior vena cava (IVC) by assessing techniques utilized, perioperative outcomes, complications, and long-term patency of the IVC. Methods: A retrospective review was performed on all robotic surgeries involving dissection and repair of the IVC at our institution. Patient characteristics, operative reports, and follow-up visits were analyzed. Preoperative and postoperative imaging was independently reviewed by a single radiologist to determine changes in IVC diameter. Complications were analyzed according to early (<30 days) vs late (>30 days). Results: Thirty-four patients underwent robot assisted surgery of the vena cava from 2008 to 2018. Twenty-six cases were performed for urologic malignancy, four were performed for IVC filter explantation, and four renal vein transpositions were performed for nutcracker syndrome. Twenty-four of the 26 patients with urologic malignancy underwent radical nephrectomy with IVC tumor thrombectomy. Three cases were converted to open. Median length of stay was two nights, and mean estimated blood loss (EBL) was 375 mL. There were five complications, ranging from Clavien-Dindo grade II-IIIa, four of which were early complications. No patients required return to the operating room, and there were no perioperative mortalities. IVC diameter was reduced by 41% on axial diameter, with no patients experiencing compromised venous return. Conclusion: Robot assisted surgery offers the advantage of minimally invasive surgery with the ability to apply open surgical principles. In our series, an experienced multidisciplinary team approach yielded low EBL, short length of stay, and low complication rates.

AB - Introduction: This study aims to describe robot assisted surgery of the inferior vena cava (IVC) by assessing techniques utilized, perioperative outcomes, complications, and long-term patency of the IVC. Methods: A retrospective review was performed on all robotic surgeries involving dissection and repair of the IVC at our institution. Patient characteristics, operative reports, and follow-up visits were analyzed. Preoperative and postoperative imaging was independently reviewed by a single radiologist to determine changes in IVC diameter. Complications were analyzed according to early (<30 days) vs late (>30 days). Results: Thirty-four patients underwent robot assisted surgery of the vena cava from 2008 to 2018. Twenty-six cases were performed for urologic malignancy, four were performed for IVC filter explantation, and four renal vein transpositions were performed for nutcracker syndrome. Twenty-four of the 26 patients with urologic malignancy underwent radical nephrectomy with IVC tumor thrombectomy. Three cases were converted to open. Median length of stay was two nights, and mean estimated blood loss (EBL) was 375 mL. There were five complications, ranging from Clavien-Dindo grade II-IIIa, four of which were early complications. No patients required return to the operating room, and there were no perioperative mortalities. IVC diameter was reduced by 41% on axial diameter, with no patients experiencing compromised venous return. Conclusion: Robot assisted surgery offers the advantage of minimally invasive surgery with the ability to apply open surgical principles. In our series, an experienced multidisciplinary team approach yielded low EBL, short length of stay, and low complication rates.

KW - inferior vena cava filter

KW - nutcracker syndrome

KW - robot assisted

KW - tumor thrombus

KW - vena cava

UR - http://www.scopus.com/inward/record.url?scp=85076447833&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85076447833&partnerID=8YFLogxK

U2 - 10.1089/end.2019.0429

DO - 10.1089/end.2019.0429

M3 - Article

C2 - 31588787

AN - SCOPUS:85076447833

VL - 33

SP - 1009

EP - 1016

JO - Journal of Endourology

JF - Journal of Endourology

SN - 0892-7790

IS - 12

ER -