Robot-Assisted Radical Nephroureterectomy in a Patient With Horseshoe Kidney: A Case Report.

Renal pelvic carcinoma in a horseshoe kidney is rare, and reports on robotic surgery for this condition are limited. We present a case of a 64-year-old male diagnosed with right renal pelvic carcinoma in a horseshoe kidney. The patient underwent robot-assisted radical nephroureterectomy using the da Vinci Xi surgical system, with preoperative anatomical visualization enhanced by 3D imaging software (SYNAPSE VINCENT). The total operative time was 6 h and 31 min, with a blood loss of 185 mL. The procedure was completed without complications. Histopathological examination revealed invasive urothelial carcinoma (pT3, high-grade carcinoma with carcinoma in situ), with negative surgical margins. In conclusion, robot-assisted radical nephroureterectomy is a feasible and safe approach for managing renal pelvic carcinoma in a horseshoe kidney. Preoperative 3D imaging enhances anatomical understanding, potentially improving surgical outcomes.