A Case of Incomplete Removal of Horseshoe Kidney by Laparoscopic Nephrectomy in an Adult Leading to Urinary Leak: An Eye Opener

Abstract

Horseshoe kidney is a common congenital fusion anomaly of the kidneys. It poses a challenge to surgeon because of its very variable anatomy in terms of location and lie, fusion, pelvicalyceal system, and the renal vessels. Here we describe a case of laparoscopic nephrectomy in a horseshoe kidney complicated by incomplete removal because of not realizing the lower and medial extent of pelvicalyceal system across midline to the contralateral side leading to persistent urine leak. The relevant anatomy and the necessary precautions to prevent such complication have been discussed.

En Bloc Transplantation of Horseshoe Kidney from Deceased Donor: An Unusual Transplantation Utilizing Kidneys with Congenital Fusion Abnormality

“…We opted to transplant en bloc as isthmusectomy could have resulted in ischemic injury to the lower pole of at least one kidney due to its shared vascularity. There have been reports of the development of ischemia and urinary leak in the transplanted kidneys after isthmusectomy [ 2 , 3 , 9 ]. As a result, division of the horseshoe kidney can result in rendering one of the kidneys nonusable due to these injuries.…”