Laparoscopic left radical nephrectomy and hand-assisted isthmectomy of a horseshoe kidney with renal cell carcinoma.
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.
Tobias-Machado
M
M
Section of Oncology and Laparoscopy, Urological Institute, ABC Medical School, São Paulo, Brazil.
Massulo-Aguiar
M F
MF
Forseto
P H
PH
Juliano
R V
RV
Wroclawski
E R
ER
D005260:Female; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged