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Published on: July 8, 2025
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Laparoscopic horseshoe kidney isthmusectomy: four case reports
Piotr Jarzemski1, Sławomir Listopadzki1
1Department of Urology, Jan Biziel University Hospital, Bydgoszcz, Poland.
Summary
Laparoscopic isthmusectomy for horseshoe kidney is a safe and effective procedure. This minimally invasive approach offers a viable alternative to open surgery for congenital urinary tract defects, with excellent patient outcomes.
Area of Science:
- Urology
- Minimally Invasive Surgery
- Congenital Abnormalities
Background:
- Horseshoe kidney affects 0.25% of the population as a congenital urinary tract defect.
- Indications for isthmus division in horseshoe kidney remain controversial.
- Surgical correction often addresses associated anomalies concurrently.
Observation:
- This study evaluated laparoscopic isthmusectomy in 4 patients with horseshoe kidney, combined with pyeloplasty and stone removal.
- A transperitoneal approach using 4 trocars was employed, with the renal isthmus divided using bipolar scissors or an endostapler.
- The endostapler significantly expedited the isthmusectomy procedure.
Findings:
- Total operative time ranged from 4.5 to 5.5 hours, with blood loss between 40-300 ml.
- No intraoperative or postoperative complications were observed.
- Patients demonstrated rapid mobilization and oral nutrition, with discharge on the third postoperative day.
Implications:
- Laparoscopic isthmusectomy is a safe alternative to open surgery for correcting horseshoe kidney congenital defects.
- The technique shows promise for improved patient recovery and outcomes.
- Further research may clarify the controversial indications for isthmus division.
