PMC9239762_01
(a) CT findings. CT reveals a mass lesion of upper pelvis of the left side of the horseshoe kidney (arrow). (b) MRI findings. MRI reveals a high signal intensity on diffusion-weighted imaging (arrow). (c) Reconstruction of three-dimensional analysis of the images of thin-slice contrast-enhanced CT. Three-dimensional reconstruction reveals two renal arteries arising from the aorta that supplied to the left side of the horseshoe kidney (arrow).
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In May 2021, CT and magnetic resonance image (MRI) revealed a mass lesion of the upper pelvis of the left side of the horseshoe kidney (Figures 1(a) and 1(b)). Preoperative thin-slice contrast-enhanced CT was performed with reconstruction of three-dimensional analysis of the images (SYNAPSE VINCENT, FUJIFILM, Tokyo, Japan), which revealed that two arteries arising from the aorta supplied the left moiety of the horseshoe kidney (Figure 1(c)).
(a) The placement of the trocar port and an incision for removal of the extirpating organs. Black circle: operator's port. Black triangle: camera port. Black square: assistant's port. Black rectangle: six cm incision for removal of extirpating organs. (b) Interruption of blood flow is confirmed between the left moiety and the right moiety visualized by indocyanine green (ICG) fluorescence system. The green region shows blood flow to the right moiety.
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The patient underwent laparoscopic transperitoneal nephroureterectomy with heminephrectomy on the left side of the horseshoe kidney in the right decubitus position in July 2021 (Figure 2(a)). We confirmed interruption of blood flow to the left moiety and blood flow to the right moiety visualized by indocyanine green (ICG) fluorescence system (PINPOINT Endoscopic fluorescence imaging system, Stryker, Michigan, USA) (Figure 2(b)).