Endoscopic combined intrarenal surgery for staghorn calculus in a horseshoe kidney with double collecting system: A case report.

Horseshoe kidney (HSK) with a duplicated collecting system and a bifid ureter is a unique surgical challenge. We report the case of a 43-year-old male patient with a left HSK, duplicated collecting system, bifid ureter, staghorn calculus in the lower moiety, and proximal ureteral stone. The procedure of mini-endoscopic combined intrarenal surgery (mECIRS) with mini-percutaneous nephrolithotomy (mini-PCNL) was successfully performed, resulting in minimal blood loss and no intraoperative complications. This case exemplifies the feasibility of employing mECIRS with a single-tract, tubeless mini-PCNL, combined with flexible ureteroscopy, to achieve complete stone clearance in a rare and challenging anatomical context.