A case of robot-assisted radical nephroureterectomy (RANU) in a patient with horseshoe kidney

Abstract

Abstract Background: Renal pelvic carcinoma occurring in a horseshoe kidney is rare. Further, there are few reports on robotic surgery in horseshoe kidneys. We report the case of a patient who underwent a robotic nephroureterectomy for right renal pelvic carcinoma in a horseshoe kidney. Case presentation: A 64-year-old male patient was diagnosed with right renal pelvic carcinoma (cT1N0M0) in a horseshoe kidney. Robot-assisted radical nephroureterectomy was performed using the da Vinci Xi® surgical system with imaging of the anatomical structures using 3D constructed imaging software (SYNAPSE VINCENT®). The isthmus was dissected using monopolar curved scissors, and the edge was coagulated using ball electrodes. The operating time was 6 h 31 min, and console time was 5 h 2 min. Blood loss was 185 mL. The surgery was performed without complications, and the patient was discharged after 8 days. The pathological diagnosis was invasive urothelial carcinoma (pT3, high-grade carcinoma with CIS) with a negative surgical margin. Conclusion: Robotic surgical procedures are safe in radical nephroureterectomy in a horseshoe kidney, and preoperative 3D construction images provide anatomical perception.