Use of a combined retroperitoneoscopic and transperitoneal laparoscopic technique for the management of renal cell carcinoma with level I tumor thrombi
A 70-year-old man was referred to our department with an 11 × 10 × 8 cm stage T3b (2009 TNM classification system) right renal tumor extending into the vena and was evaluated with contrast enhanced computed tomography (CT). The radiology department reported that the tumor thrombus in the renal vein extended 2 cm into the vena cava and that there was no evidence of hilar lymphadenopathy []. In addition, a second tumor measuring 3 × 3 × 3 cm was detected at the upper pole of the left kidney. The patient's thorax CT and bone scan were negative. After obtaining the consent of the patient, we decided to perform a LRN using a combined retroperitoneoscopic and transperitoneal technique.