Laparoscopic Level II thrombectomy for renal cell carcinoma: An index case report from a national tertiary hospital

Renal cell carcinoma (RCC) with inferior vena cava (IVC) thrombosis is a rare and complex condition. Most cases have been managed through open surgery, particularly in premier institutes in Nepal. However, no published literature currently exists regarding laparoscopic management of such cases in this region.

We present an index case of right RCC with IVC thrombosis managed laparoscopically at a tertiary cancer center in Nepal. The patient had a history of prior abdominal surgery, which led to dense adhesions complicating the laparoscopic procedure. Despite these challenges, the laparoscopic approach was successfully performed, offering a minimally invasive alternative to traditional open surgery.

The major challenges in this case included managing the dense adhesions from the previous surgery, which significantly hindered the laparoscopic dissection and exposure of the IVC. Additionally, the complexity of tumor removal and IVC thrombectomy posed a significant technical challenge.

Surgical treatment for RCC with IVC thrombus is highly complex, carrying significant risk of peri-operative mortality, and is best performed in a high-volume centre.