title: Laparoscopic left radical nephrectomy and hand-assisted isthmectomy of a horseshoe kidney with renal cell carcinoma.
abstract: A 64-year-old woman presented with recurrent gross hematuria and intermittent left-sided pain. A CT scan revealed an 8-cm mass in the left moiety of a horseshoe kidney. A laparoscopic transperitoneal approach was employed to control the vessels and release the left moiety of the kidney and a hand-assisted approach was performed for isthmectomy using compression of normal parenchyma and monopolar electrocautery. Additional sutures were applied externally in isthmus through hand-assisted incision to enhance hemostasis. The patient was discharged on postoperative day 4 with no complications and no relapse after a 1-year follow-up. We conclude that our technique is safe, cheap and effective for this complex clinical entity.
authors.affiliation: Section of Oncology and Laparoscopy, Urological Institute, ABC Medical School, São Paulo, Brazil.
authors.forename: M
authors.initials: M
authors.lastname: Tobias-Machado
authors.forename: M F
authors.initials: MF
authors.lastname: Massulo-Aguiar
authors.forename: P H
authors.initials: PH
authors.lastname: Forseto
authors.forename: R V
authors.initials: RV
authors.lastname: Juliano
authors.forename: E R
authors.initials: ER
authors.lastname: Wroclawski
mesh_terms: D005260:Female; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged