Robot‐assisted laparoscopic partial nephrectomy for horseshoe kidney: A case report

Abstract

Introduction Horseshoe kidney has unique anatomical features, such as a complex blood supply. We report a patient with renal cell carcinoma in a horseshoe kidney, who underwent tumor resection by robot‐assisted laparoscopic partial nephrectomy based on preoperative three‐dimensional computed tomography. Case presentation A 66‐year‐old man was referred to our hospital with a 2‐cm enhancing mid‐pole mass in the left moiety of a horseshoe kidney. The clinical diagnosis was renal cell carcinoma cT1aN0M0 (R.E.N.A.L. nephrometry score: 1 + 2 + 3 + 3 = 9p). Robot‐assisted laparoscopic partial nephrectomy was performed with selective clamping based on reconstructed three‐dimensional images. The warm ischemia time was 13 min. Pathologic examination confirmed a diagnosis of pT1a clear cell renal cell carcinoma with negative surgical margins. At 6 months postoperatively, computed tomography showed no local recurrence or metastasis and renal function was intact. Conclusion Robot‐assisted laparoscopic partial nephrectomy with preoperative three‐dimensional computed tomography may have advantages for resection of tumors in patients with horseshoe kidney.

Editorial Comment to Robot‐assisted laparoscopic partial nephrectomy for horseshoe kidney: A case report

“…The 3D reconstruction images have been published in 6 of 10 previous case reports of LPN or RAPN for HSK. However, there have been only three recent case reports (including the present case) in which the contour and positional relationships among the renal parenchyma, tumor, and renal arteries were clearly identified …”

“…In the present case report, Fujihara et al . reported the third successful case of RAPN for HSK . The renal mass, which had a diameter of 2 cm in the lateral mid‐pole of the left moiety, was resected using the transperitoneal RAPN procedure.…”

Retroperitoneal Robot-Assisted Laparoscopic Partial Nephrectomy for Horseshoe Kidney: A Case Report

“…Until now, there are only 4 cases that characterizes robot-assisted partial or heminephrectomy for renal tumors with fusion anomalies of the kidney [2,[14][15][16]. Three of them reported the surgery was performed through a transperitoneal approach [14][15][16]. To our knowledge, this is the rst study reported retroperitoneal robotassisted laparoscopic partial nephrectomy with HSK.…”

“…Molina WR et al [13] also documented that retroperitoneal approach may work better for tumors located in posterolateral side. Until now, there are only 4 cases that characterizes robot-assisted partial or heminephrectomy for renal tumors with fusion anomalies of the kidney [2,[14][15][16]. Three of them reported the surgery was performed through a transperitoneal approach [14][15][16].…”

Robot‐assisted partial nephrectomy via retroperitoneal approach in a patient with horseshoe kidney

“…Moreover, only four cases of RAPN in patients with HSK have been described in the literature (Table 1). 11–14 Due to its good visibility with 3D images and free operability of forceps, RAPN has the advantage of resection of the tumor and sutring of renal parenchyma compared with conventional laparoscopic procedures. However, the HSK requires extensive dissection to handle its poor mobility and identification of various vasculatures.…”