**7.3 Minimally invasive IVC tumor thrombectomy**

Patients with Venous tumor thrombus (VTT) have a guarded prognosis with an estimated 1-year survival of 29% without surgery [25]. Aggressive surgical management with complete resection of tumor thrombus is the only treatment option that offers the potential for cure in these patients which is a technically and physically demanding procedure, and has traditionally been performed open surgically with significant associated risks of perioperative morbidity and mortality [1]. LRN has been used predominantly for level I–II thrombi [26–33]. The procedure is technically demanding even in the hands of experienced laparoscopic surgeons in view of rigid instrumentation, restricted movements, transmitted physiological tremor, prolonged learning curve and more specifically difficulty in suture repair of the IVC and controlling major intra- abdominal bleeding [1].
