case_images: PMC4718300_01
case_images: The MRI (T2) scan (A) showed the horseshoe kidney in this patient, and MRU (B) demonstrated the left kidney is hydronephrosis and UPJO. MRI = magnetic resonance imaging, MRU = magnetic resonance urography, UPJO = ureteropelvic junction obstruction.
case_images: medi-95-e2516-g001.jpg
case_images: PMC4718300_01_medi-95-e2516-g001.jpg
case_images: F1
case_images: The magnetic resonance imaging and magnetic resonance urography scans demonstrated a horseshoe kidney with concomitant left UPJO and hydronephrosis (Figure 1A and B).
case_images: The patient was in a semilateral decubitus position and 5 ports position were illustrated in A, B, C. The da Vinci robotic-assisted laparoscopy system was assembled (D).
case_images: medi-95-e2516-g002.jpg
case_images: PMC4718300_01_medi-95-e2516-g002.jpg
case_images: F2
case_images: The patient was rolled into a semilateral decubitus position rotating the operative side up by 45 axially (Figure 2A). The 5 trocars placement was performed (Figure 2A and B).
case_images: The ectopic and ovary veins were divided (A). The isthmus of horseshoe kidney was separated, stitched, and divided (B, C). The pyeloplasty was performed (D).
case_images: medi-95-e2516-g003.jpg
case_images: PMC4718300_01_medi-95-e2516-g003.jpg
case_images: F3
case_images: The ectopic renal and left ovary veins were divided and cut, respectively (Figure 3A [see Video, Supplemental Video, which demonstrates the details of procedure]). The robotic dissector was placed under the isthmus when it was raised upward (Figure 3B and C [see Video, Supplemental Video, which demonstrates the details of procedure]). F6 double J stent was placed in an ante-grade manner, and then the posterior and anterior aspects of the pelvic-ureteric anastomosis were both done by the 4-0 absorbable running suture (Figure 3D). Finally, 1 drainage tube was placed (see Video, Supplemental Video, which demonstrates the details of procedure).
case_images: The IVP showed the good renal function and improved drainage at 11.5 months after surgery. IVP = intravenous pyelography.
case_images: medi-95-e2516-g004.jpg
case_images: PMC4718300_01_medi-95-e2516-g004.jpg
case_images: F4
case_images: Following up, the IVP exam showed this female patient had good renal function and improved drainage at 11.5 months after surgery (Figure 4).