Modified pump-driven venous bypass in surgery for renal cell carcinoma (RCC) involving the inferior vena cava (IVC).

Surgical management of renal cell carcinoma (RCC) with a tumour thrombus that infiltrates the caval wall or extends above the hepatic veins can be problematic. Total control of the suprahepatic inferior vena cava (IVC) is mandatory in order to prevent thrombus mobilization and minimize blood loss. Pump-driven veno-venous bypass (VVB), modified by adding portal decompression, is a safe and useful procedure and avoids the important risks connected with deep hypothermic circulatory arrest while allowing the normal perfusion of vital organs.