[Application of robot-assisted laparoscopic isthmectomy for the treatment of symptomatic horseshoe kidney]

The current study aimed to investigate the feasibility and safety of robot-assisted laparoscopic resection of the isthmus in patients with symptomatic horseshoe kidney. A retrospective analysis of clinical data from four patients with symptomatic horseshoe kidney treated between January 1, 2021 and December 31, 2023 at Guizhou Provincial People's Hospital was conducted. The main surgical procedures included robot-assisted laparoscopic resection of the isthmus, kidney fixation, pyeloplasty, and pyelolithotomy. All four patients underwent successful surgery. One patient had concomitant calculi. The mean operative time was 179.8 minutes, with an average blood loss of 49.5 ml. In patients followed up for 3 months, 6 months, 1 year, and 2 years postoperatively, renal anatomy remained normal, significant improvement in hydronephrosis was observed compared to preoperative status, serum creatinine levels returned (maintained) to normal status, and no surgery-related complications occurred during the perioperative period. This study reports the safety and feasibility of robot-assisted laparoscopic resection of the isthmus in patients with symptomatic horseshoe kidney. This surgical approach effectively restores the abnormal anatomical structure of the horseshoe kidney, reestablishes the natural course of the ureter, and prevents compression of the ureter by the isthmus of the horseshoe kidney.