Transdiaphragmatic-intrapericardiac approach to supradiaphragmatic vena cava invasion secondary to renal cell carcinoma: A novel surgical approach

This technique allows excellent exposure of the supradiaphragmatic inferior vena cava through a 10-cm incision and optimal control of the distal thrombus edge when it reaches the right atrium. This approach is safer, faster, easier, and minimally invasive and avoids cardiopulmonary bypass with deep hypothermic cardiac arrest or venovenous bypass.