PMC9812624_01
Placement of the hand port and trocars.
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fig1
The port layout is shown in Figure 1.
Schema of vascular processing in hand-assisted laparoscopic nephrectomy. (a) Thrombus tip is hooked using a vessel loop. (b) Thrombus is pulled up using the vessel loop, creating space for it to be processed using the Endo GIA stapler.
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fig2
The schema of vessel processing using a vessel loop is shown in Figure 2.
Imaging and intraoperative findings of the cases of right renal cell carcinoma (RCC) with thrombus ((a, b) case 1 and (c, d) case 2). (a) Computed tomography demonstrated a renal tumor thrombus extending 0.5 cm into the inferior vena cava. (b) The tumor was pulled up within the renal vein using the vessel loop, and the renal vein was divided using the Endo GIA stapler. (c) Magnetic resonance imaging demonstrated a renal tumor thrombus within the renal vein. (d) The tumor was pulled up using the vessel loop, and the renal vein was divided using the Endo GIA stapler. Arrowheads indicate the tip of the tumor thrombus.
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fig3
 Figure 3 shows computed tomography (CT) or magnetic resonance imaging and intraoperative findings of the cases with right RCC (cases 1 and 2), and Figure 4 shows those of the case with left RCC (case 3).
Imaging and intraoperative findings of the cases with left renal cell carcinoma with thrombus (case 3). (a) Computed tomography demonstrated a thrombus extending 2 mm beyond the right aortic border. (b) A vessel loop hooked to the thrombus tip. (c) The thrombus was pulled up using a vessel loop. (d) The left renal vein was dissected using Hem-o-lok clips. Arrowheads indicate the tip of the tumor thrombus.
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fig4
 Figure 3 shows computed tomography (CT) or magnetic resonance imaging and intraoperative findings of the cases with right RCC (cases 1 and 2), and Figure 4 shows those of the case with left RCC (case 3).