Abstract

  A 22-year-old woman was referred to our hospital with chief complaint of left flank pain and fever. She was diagnosed as left pyonephrosis associated with left ureteropelvic junction obstruction of horseshoe kidney. We performed a laparoscopic left heminephrectomy, because any conservative treatment was not successful, and renal function of left moiety significantly reduced. The feeding vessels consisted of two arteries, which of them directly supplied the lower pole of the kidney from aorta. As the presence of double inferior vena cava, we required very careful manner to the left half kidney and isthmus. A Endo-GIA™（60AXT）divided the isthmus with excellent hemostasis and needed no additional suture. Total operative time was 270 minutes and estimated blood loss was negligible. Laparoscopic heminephrectomy for a horseshoe kidney becomes very useful surgical procedure by fully preoperative consideration of feeding arteries of the horseshoe kidney and selection of device with the isthmusectomy.