Fig. 2

The surgical schematic showed the patient’s position and the placement of the trocar. For patients with left renal cell carcinoma with tumor thrombus. A Schematic diagram of patient position. The patient was placed in the right lateral decubitus position with chest pillow and tilted to the back by 30°. B Schematic diagram of the placement of the trocar. A 12-mm trocar (No. 1) was placed into the left lateral border of the rectus muscle under the 11th rib, and a laparoscope was placed. Under the direct laparoscopic vision, an 8-mm trocar (No. 2) was placed into the left lateral border of the rectus muscle under the costal margin for insertion of unipolar electric shear or needle holder. Another 8-mm trocar (No. 3) was placed on the inside of the iliac spine near the rectus muscle for inserting Maryland bipolar coagulation forceps, window grasping forceps, etc. A 12-mm trocar (No. 4) was placed around the umbilicus in the anterior midline, and another 12-mm trocar (No. 5) was placed 8 cm above the umbilicus. The auxiliary hole is used to insert a laparoscopic vascular clamp, suction, or serrefine. C Schematic diagram of the patient's position after changing the position. Patients were then repositioned in the left lateral decubitus position with chest pillow and tilted to the back by 30°. D Schematic diagram of the placement of the trocar after changing the position. An 8-mm trocar was placed into the right lateral border of the rectus muscle under the 11th rib, and a laparoscope was placed. Under the direct laparoscopic vision, two 8-mm trocars were placed into the right lateral border of the rectus muscle under the costal margin and on the inside of the iliac spine near the rectus muscle, and a 5-mm trocar was placed under the xiphoid