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Robot-assisted laparoscopic partial nephrectomy for horseshoe kidney: A case report.
Atsuko Fujihara1, Fumiya Hongo1, Tsukasa Narukawa1
1Department of Urology Kyoto Prefectural University of Medicine Kyoto Japan.
IJU Case Reports
|August 4, 2020
Summary
Robot-assisted partial nephrectomy using 3D CT is effective for horseshoe kidney tumors. This minimally invasive approach offers advantages for complex renal anatomy, ensuring tumor removal with preserved kidney function.
Area of Science:
- Urology
- Surgical Oncology
- Medical Imaging
Background:
- Horseshoe kidney presents unique anatomical challenges, including complex vascularity, complicating renal tumor management.
- Renal cell carcinoma (RCC) in horseshoe kidneys requires specialized surgical techniques for successful resection.
- Preoperative 3D computed tomography (CT) aids in visualizing complex renal anatomy.
Observation:
- A 66-year-old male presented with a 2-cm enhancing mass in a horseshoe kidney, diagnosed as cT1aN0M0 renal cell carcinoma.
- The R.E.N.A.L. nephrometry score was 9p, indicating a complex tumor.
- Robot-assisted laparoscopic partial nephrectomy was performed using 3D CT reconstructions for precise surgical planning.
Findings:
- The procedure involved selective vascular clamping, achieving a warm ischemia time of 13 minutes.
- Pathology confirmed pT1a clear cell renal cell carcinoma with negative surgical margins.
- Postoperative follow-up at 6 months showed no recurrence or metastasis, with intact renal function.
Implications:
- Robot-assisted laparoscopic partial nephrectomy, guided by 3D CT, demonstrates feasibility and safety for RCC in horseshoe kidneys.
- This approach may offer advantages in managing complex renal tumors within anomalous renal structures.
- Enhanced preoperative imaging and minimally invasive techniques improve oncological and functional outcomes in challenging urological cases.
