Category: Laparoscopic/ Robotic: Renal

VS17-11 - A Case of Robotic-Assisted Partial Nephrectomy in a Horseshoe Kidney.

Sun, Sep 23
2:00 PM - 4:00 PM

Introduction & Objective :

Horseshoe kidney (HSK) is a renal fusion anomaly found in about 0.15% to 0.25% of the population. Because of limited mobilization of the kidney and its multiple arterial blood supplies, minimally invasive surgery for renal tumors can be challenging.


Methods : A 79-year-old woman visited our department with a left renal tumor discovered by scrutiny of carcinoembryonic antigen high value. Computed tomography (CT) revealed a horseshoe kidney and an approximately 19-mm tumor in the left upper pole. There was no evidence of lymph node and distant metastases.


Results : Under a clinical diagnosis of a renal cell carcinoma (cT1aN0M0), the patient underwent robotic-assisted partial nephrectomy (RAPN). Some arteries run to an isthmus of the horseshoe kidney, but simulation of blood supply with SYNAPSE VINCENT® showed that only left renal artery was the feeding artery of the tumor. Left renal artery was clamped and the operation was performed safely. The operation time was 241 minutes and the console time was 123 minutes and the warm ischemia time was 19 minutes. The postoperative course was uneventful and the patient left the hospital on the 9th postoperative day.


Conclusions :

RAPN in a HSK is feasible procedure for carefully selected patients. We could perform the operation safely with preoperative simulation with three-dimensional models of blood supply.

Ryoma Nishikawa

Graduate Student
Department of Urology, Tottori University Faculty of Medicine
Yonago, Tottori, Japan

I am Ryoma Nishikawa, M.D., a graduate student of Department of Urology, Tottori University Faculty of Medicine.
2013.3 Graduated from Tottori University Faculty of Medicine
2013.4 Started resident program of Yonago Medical Center
2015.3 Finished resident program
2015.4 Clinical fellow of Department of Urology, Tottori University Faculty of Medicine
2016.4 Entered a graduate school of Tottori University Faculty of Medicine

Hiroshi Yamane

Yonago, Tottori, Japan

Yuri Nishikawa

Yonago, Tottori, Japan

Shogo Teraoka

Medical staff
Department of Urology, Tottori University Faculty of Medicine
Yonago, Tottori, Japan

I am Shogo Teraoka, M.D., a medical staff of Department of Urology, Tottori University Faculty of Medicine.
2013.3 Graduated from Tottori University Faculty of Medicine
2013.4 Started resident program of Tottori Prefectural Central Hospital
2015.3 Finished resident program
2015.4 Clinical fellow of Department of Urology, Tottori University Faculty of Medicine
2016.4 Entered a graduate school of Tottori University Faculty of Medicine

Yusuke Kimura

Assistant Professor
Department of Urology, Tottori University Faculty of Medicine
Yonago, Tottori, Japan

Tetsuya Yumioka

Department of Urology, Tottori University Faculty of Medicine
Yonago, Tottori, Japan

Hideto Iwamoto

Department of Urology, Tottori University Faculty of Medicine
Yonago, Tottori, Japan

Shuichi Morizane

Senior Lecturer
Department of Urology, Tottori University Faculty of Medicine
Yonago, Tottori, Japan

2001 M.D., Tottori University School of Medicine, Yonago, Japan
2006 Ph.D., Tottori University School of Medicine, Department of Urology
2006 Department of Urology, Tottori University Faculty of Medicine, Assistant Professor
2016 Department of Urology, Tottori University Faculty of Medicine, Senior Lecturer

Katsuya Hikita

Senior Lecturer
Department of Urology, Tottori University Faculty of Medicine
Yonago, Tottori, Japan

Masashi Honda

Associate Professor
Department of Urology, Tottori University Faculty of Medicine
Yonago, Tottori, Japan

Masashi Honda, M.D., Ph.D., Associate Professor in Div. of Urology, Dept. of Surgery, Tottori University Facluty of Medicine, Yonago, Japan

APPOINTMENTS/EMPLOYMENT
2017−present Associate Professor in Div. of Urology, Dept. of Surgery, Tottori University Faculty of Medicine.
2016−present Delegate of the Japanese Urological Association.
2016−present Delegate of the Japanese Society of Endourology.
2016−2017 Senior Assistant Professor in in Div. of Urology, Dept. of Surgery, Tottori University Faculty of Medicine.
2014−present Delegate of the Japanese Continence Society.
2011−2016 Senior Assistant Professor in Dept. of Urology, Tottori University Hospital.
2007−2011 Assistant Professor in Dept. of Urology, Tottori University Hospital.
2006−2007 Research Fellow in Dept. of Urology, University of Pittsburgh, Pittsburgh, USA.
2003−2006 Assistant Professor in Dept. of Urology, Tottori University Hospital.
1997−1998 Resident in Dept. of Urology, Tottori University Hospital.

EDUCATION
Entered Tottori University Faculty of Medicine, April, 1991, and graduated March, 1997, with the degree of Bachelor of Medicine.
Obtained an M.D.. May, 1997.
Entered Dept. of Urology, Tottori University Graduate School of Medicine, April, 1998, and graduated March, 2002, with the degree of Ph.D.

Atsushi Takenaka

Professor
Department of Urology, Tottori University Faculty of Medicine
Yonago, Tottori, Japan