The thoracic cavity, a troublesome neighbor. Intraoperative consultation by the thoracic surgeon.

There is usually little need for intraoperative collaboration between the thoracic surgeon and his urologic colleague. However, situations occasionally arise in the urologist's operating room that require consultation with a thoracic surgeon or the use of thoracic surgical techniques. These techniques may be required during intrathoracic complications of common anesthetic procedures, or when renal pathology is extensive and demands cooperation between the specialties. The propensity of renal-cell carcinoma to extend via the renal vein into the inferior vena cava and right atrium may, on occasion, require direct surgical cooperation between the cardiac and urologic surgeon to remove safely large tumors that extend into and perhaps adhere to the right atrium.