Re: Baojun Wang, Qingbo Huang, Kan Liu, et al. Robot-assisted Level III-IV Inferior Vena Cava Thrombectomy: Initial Series with Step-by-step Procedures and 1-yr Outcomes. Eur Urol. In press. https://doi.org/10.1016/j.eururo.2019.04.019 (European Urology)

Although the available experience is limited, it seems clear that robotic assistance has extended the laparoscopic surgical indication in renal cell carcinoma (RCC). Wang et al [1] recently reported their experience in using this approach in RCC with inferior vena cava (IVC) level III-IV tumor thrombi and provided an excellent description of the procedure. However, we believe that several issues warrant further discussion.