Abstract
Clinical History:
A 71-year-old male was referred to our department after an incidental finding of right renal tumor in a horseshoe kidney during routine health examination. No hematuria was reported.
Physical Exam:
Right renal angle tenderness on percussion. No palpable abdominal mass.
Diagnosis:
Preoperative contrast-enhanced CT revealed a solid mass with severe hydronephrosis in the right kidney of the horseshoe kidney. Clinical TNM stage was cT1aN0M0.
Intervention:
Robot-assisted heminephrectomy was performed with the patient in 30° Trendelenburg position. An open Hasson technique was used to place the camera port 5 cm below the umbilicus, with four additional ports placed for optimal access. The ascending colon and duodenum were mobilized to expose the right ureter and isthmus. The isthmus was carefully separated and divided using a 45-mm endostapler after creating a tunnel between the isthmus and vascular structures. Renal vessels were controlled using Hem-o-lok clips and endostapler. The kidney was retrieved via an extended lower port using a retrieval bag.
Follow-Up/Outcomes:
The procedure was completed without intraoperative or postoperative complications. The total operative time was 50 minutes, and the estimated blood loss was 5 mL. The patient had an uneventful recovery and was discharged on postoperative day 2. Pathology findings confirmed the diagnosis of right renal clear cell renal cell carcinoma. The tumor was classified as WHO/ISUP nuclear grade 3 out of 4 and staged as pT1aN0M0.
Patient Consent Statement:
The authors have received and archived patient consent for video recording/publication in advance of video recording the procedure.
Author Disclosure Statement:
The authors declare no conflicts of interest.
Funding:
The study was supported by the Natural Science Foundation of Guangdong Province (No. 2023A1515011664).
Runtime of video: 4 mins 33 secs.
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