The removal of renal carcinoma thrombus extending into the right atrium

A relatively simple technique is described for removal of intra-atrial extension of renal cell carcinoma. A balloon catheter is inserted through an incision in the inferior vena cava and inflated in the atrium. Coupled with an elevation of venous pressure this procedure provides control beyond the tumor and a mechanism for withdrawal of the tumor to the abdominal venotomy for extraction. Radical nephrectomy and resection of directly invaded cava complete a definitive surgical procedure. The technique has proved satisfactory in 2 patients.