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.