Robot-Assisted Hepatic Mobilization And Control Of Suprahepatic Infradiaphragmatic Inferior Vena Cava For Level 3 Vena Caval Thrombectomy: An IDEAL Stage 0 Study

Robot-assisted level 1/2 inferior vena caval (IVC) thrombectomy techniques have been recently described for clinical use. Following the IDEAL recommendations on safe surgical innovation, we here describe a robotic approach for level 3 IVC thrombectomy in fresh frozen cadavers (IDEAL stage 0). In all cadavers (n = 3), hepatic mobilization with control of short hepatic veins, contralateral renal vein, infrarenal IVC and suprahepatic-infradiaphragmatic IVC could be achieved successfully, without converting to open surgery. Clinical feasibility of our technique remains to be tested. (C) 2015 Wiley Periodicals, Inc.