A 63-year-old woman with an incidentally detected 10-cm enhancing renal mass in the left moiety of a horseshoe kidney was treated with a transperitoneal hand-assisted laparoscopic (HAL) radical heminephrectomy. The operative time was 273 minutes, and estimated blood loss was 250 mL. To our knowledge, this is the initial case of HAL radical heminephrectomy for renal-cell carcinoma in a horseshoe kidney. Appropriate pre-operative imaging and surgical technique for the isthmusectomy are highlighted.
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