Updates Presented on Robotic Vena Cava Surgery

 

Developments in robotic vena cava surgery will be presented Friday afternoon during the session entitled “Endovascular and Open Solutions for Inferior Vena Cava Tumors and Occusions, Vena Cava Filtration Strategies, Pitfalls, and Complications and More About Iliac Vein Stenting.”

Dr. Samuel R. Money of Mayo Clinic College of Medicine will discuss the way in which continued refinement of robotic vena cava surgery has allowed vena caval arterial surgery to catch up with other minimally invasive vena cava procedures in terms of utility and patient outcome. His paper is “Robotic Vena Cava Surgery.”

“The selective use of robotic surgery on the vena cava is a tremendous step forward because of its minimal invasiveness and also because of the magnification that the robot gives and the technical advantages the robot gives over open surgery or laparoscopic surgery,” said Dr. Money.

Traditionally, inferior vena cava thrombectomy is done using a large open incision, since it is difficult otherwise to gain access to the vein. The surgery is done most often to address involvement of the inferior vena cava by an adjacent tumor. In addition, surgery may be needed to remove filters inserted to prevent migration of pulmonary emboli when problems develop with the filter.

The open incision approach carries a considerable risk of morbidity with the approach. A minimally invasive treatment option has been needed. Minimally invasive laparoscopy is an option. But drawbacks include the technically challenging nature of the procedure which makes for a steep learning curve.

Within the past decade, the use of robotic surgery has been utilized for interior vena cava thrombectomy. The approach involves multiple but smaller incisions to allow access of robotic tools. The robotic approach provides better visualization with magnification, three-dimensional vision, tremor filtration, and seven degrees of freedom, among other advantages.

“The overall take-home message from my presentation is that robotic vena caval surgery can be done and it should be used. Overall, robotic surgery for the vena cava is a field that is developing. It requires collaboration with other specialties and a realization that minimally invasive procedures are not just endovascular procedures but may be laparoscopic or robotic in nature,” said Dr. Money.

Dr. Money will describe the outcomes of a prospective study undertaken at the Scottsdale Mayo Clinic that evaluated the efficacy of a vena cava surgical system for radical nephrectomy and inferior vena cava tumor thrombectomy and, in a few patients, inferior vena cava filter removal. More recently, the robotic surgery was used to treat compression of the left renal vein between the superior mesenteric artery and aorta.

A focus of the presentation will be the key importance of the collaboration between vascular and robotic surgeons. “As time has developed I have become more aware and more adept at what the robot can do. However, it is not a routine part of my practice. By collaborating with others who use it more frequently, we have developed a practice where vena caval surgery can be done in a minimally invasive fashion with patients going home following a shorter length of stay, with less significant blood loss, and overall an easier recovery,” said Dr. Money.


Session 91:Endovascular and Open Solutions for Inferior Vena Cava Tumors and Occusions, Vena Cava Filtration Strategies, Pitfalls, and Complications and More About Iliac Vein Stenting

Robotic Vena Cava Surgery
Friday, 3:48 p.m. – 3:53 p.m.
Trianon Ballroom, 3rd Floor

 

Developments in robotic vena cava surgery will be presented Friday afternoon during the session entitled “Endovascular and Open Solutions for Inferior Vena Cava Tumors and Occusions, Vena Cava Filtration Strategies, Pitfalls, and Complications and More About Iliac Vein Stenting.”

Dr. Samuel R. Money of Mayo Clinic College of Medicine will discuss the way in which continued refinement of robotic vena cava surgery has allowed vena caval arterial surgery to catch up with other minimally invasive vena cava procedures in terms of utility and patient outcome. His paper is “Robotic Vena Cava Surgery.”

“The selective use of robotic surgery on the vena cava is a tremendous step forward because of its minimal invasiveness and also because of the magnification that the robot gives and the technical advantages the robot gives over open surgery or laparoscopic surgery,” said Dr. Money.

Traditionally, inferior vena cava thrombectomy is done using a large open incision, since it is difficult otherwise to gain access to the vein. The surgery is done most often to address involvement of the inferior vena cava by an adjacent tumor. In addition, surgery may be needed to remove filters inserted to prevent migration of pulmonary emboli when problems develop with the filter.

The open incision approach carries a considerable risk of morbidity with the approach. A minimally invasive treatment option has been needed. Minimally invasive laparoscopy is an option. But drawbacks include the technically challenging nature of the procedure which makes for a steep learning curve.

Within the past decade, the use of robotic surgery has been utilized for interior vena cava thrombectomy. The approach involves multiple but smaller incisions to allow access of robotic tools. The robotic approach provides better visualization with magnification, three-dimensional vision, tremor filtration, and seven degrees of freedom, among other advantages.

“The overall take-home message from my presentation is that robotic vena caval surgery can be done and it should be used. Overall, robotic surgery for the vena cava is a field that is developing. It requires collaboration with other specialties and a realization that minimally invasive procedures are not just endovascular procedures but may be laparoscopic or robotic in nature,” said Dr. Money.

Dr. Money will describe the outcomes of a prospective study undertaken at the Scottsdale Mayo Clinic that evaluated the efficacy of a vena cava surgical system for radical nephrectomy and inferior vena cava tumor thrombectomy and, in a few patients, inferior vena cava filter removal. More recently, the robotic surgery was used to treat compression of the left renal vein between the superior mesenteric artery and aorta.

A focus of the presentation will be the key importance of the collaboration between vascular and robotic surgeons. “As time has developed I have become more aware and more adept at what the robot can do. However, it is not a routine part of my practice. By collaborating with others who use it more frequently, we have developed a practice where vena caval surgery can be done in a minimally invasive fashion with patients going home following a shorter length of stay, with less significant blood loss, and overall an easier recovery,” said Dr. Money.


Session 91:Endovascular and Open Solutions for Inferior Vena Cava Tumors and Occusions, Vena Cava Filtration Strategies, Pitfalls, and Complications and More About Iliac Vein Stenting

Robotic Vena Cava Surgery
Friday, 3:48 p.m. – 3:53 p.m.
Trianon Ballroom, 3rd Floor

 

Developments in robotic vena cava surgery will be presented Friday afternoon during the session entitled “Endovascular and Open Solutions for Inferior Vena Cava Tumors and Occusions, Vena Cava Filtration Strategies, Pitfalls, and Complications and More About Iliac Vein Stenting.”

Dr. Samuel R. Money of Mayo Clinic College of Medicine will discuss the way in which continued refinement of robotic vena cava surgery has allowed vena caval arterial surgery to catch up with other minimally invasive vena cava procedures in terms of utility and patient outcome. His paper is “Robotic Vena Cava Surgery.”

“The selective use of robotic surgery on the vena cava is a tremendous step forward because of its minimal invasiveness and also because of the magnification that the robot gives and the technical advantages the robot gives over open surgery or laparoscopic surgery,” said Dr. Money.

Traditionally, inferior vena cava thrombectomy is done using a large open incision, since it is difficult otherwise to gain access to the vein. The surgery is done most often to address involvement of the inferior vena cava by an adjacent tumor. In addition, surgery may be needed to remove filters inserted to prevent migration of pulmonary emboli when problems develop with the filter.

The open incision approach carries a considerable risk of morbidity with the approach. A minimally invasive treatment option has been needed. Minimally invasive laparoscopy is an option. But drawbacks include the technically challenging nature of the procedure which makes for a steep learning curve.

Within the past decade, the use of robotic surgery has been utilized for interior vena cava thrombectomy. The approach involves multiple but smaller incisions to allow access of robotic tools. The robotic approach provides better visualization with magnification, three-dimensional vision, tremor filtration, and seven degrees of freedom, among other advantages.

“The overall take-home message from my presentation is that robotic vena caval surgery can be done and it should be used. Overall, robotic surgery for the vena cava is a field that is developing. It requires collaboration with other specialties and a realization that minimally invasive procedures are not just endovascular procedures but may be laparoscopic or robotic in nature,” said Dr. Money.

Dr. Money will describe the outcomes of a prospective study undertaken at the Scottsdale Mayo Clinic that evaluated the efficacy of a vena cava surgical system for radical nephrectomy and inferior vena cava tumor thrombectomy and, in a few patients, inferior vena cava filter removal. More recently, the robotic surgery was used to treat compression of the left renal vein between the superior mesenteric artery and aorta.

A focus of the presentation will be the key importance of the collaboration between vascular and robotic surgeons. “As time has developed I have become more aware and more adept at what the robot can do. However, it is not a routine part of my practice. By collaborating with others who use it more frequently, we have developed a practice where vena caval surgery can be done in a minimally invasive fashion with patients going home following a shorter length of stay, with less significant blood loss, and overall an easier recovery,” said Dr. Money.


Session 91:Endovascular and Open Solutions for Inferior Vena Cava Tumors and Occusions, Vena Cava Filtration Strategies, Pitfalls, and Complications and More About Iliac Vein Stenting

Robotic Vena Cava Surgery
Friday, 3:48 p.m. – 3:53 p.m.
Trianon Ballroom, 3rd Floor