# Minimally invasive management of horseshoe kidney with polycystic kidney disease: A case report of successful tri-dimensional laparoscopic nephrectomy in a Puerto Rican female patient

## TL;DR

A rare case of a Puerto Rican woman with two kidney conditions was successfully treated with a new 3D laparoscopic surgery, offering a safer and faster recovery.

## Contribution

First reported use of 3D laparoscopic bilateral nephrectomy for ADPKD-HSK, demonstrating its advantages over conventional techniques.

## Key findings

- 3D laparoscopy enabled precise dissection and safe removal of both kidneys in a patient with ADPKD-HSK.
- The technique improved visualization and control of complex anatomy, minimizing risks and optimizing space for future transplants.
- 3D laparoscopic nephrectomy is a safe, effective, and cost-efficient alternative to open and robotic surgeries for this rare condition.

## Abstract

The coexistence of autosomal dominant polycystic kidney disease (ADPKD) with horseshoe kidney (HSK) is rare and presents significant surgical challenges due to fused anatomy and vascular variability. We report the first 3D laparoscopic bilateral nephrectomy case for ADPKD-HSK, demonstrating its advantages over conventional techniques.

A 60-year-old woman with symptomatic ADPKD-HSK and end-stage renal disease presented with compressive symptoms. Comorbidities included diabetes, hypertension, hyperlipidemia, and AV graft dysfunction. A 3D laparoscopic approach enabled precise dissection, isthmus division, and safe removal of both kidneys. The patient experienced no intraoperative complications and recovered well postoperatively.

Nephrectomy in ADPKD-HSK is complex due to aberrant anatomy. While open surgery offers access, it carries higher morbidity. Laparoscopic nephrectomy reduces blood loss and shortens recovery—key benefits for transplant candidates. 3D laparoscopy improves visualization and vascular control at a lower cost compared to open and robotic techniques.

3D laparoscopic bilateral nephrectomy is safe, effective, and cost-efficient for ADPKD-HSK. Further studies are needed to guide the surgical management of this rare condition.

•Horseshoe kidney (HSK) and autosomal dominant polycystic kidney disease (ADPKD) are rare congenital anomalies that pose significant surgical challenges.•This is the first reported case of a 3D laparoscopic bilateral nephrectomy in a patient with ADPKD-HSK, incorporating bilateral kidney mobilization.•The 3D laparoscopic approach enhanced surgical precision and depth perception, improving visualization of complex anatomical structures.•This technique optimized anatomical space for future renal transplantation, minimizing operative risks and ensuring favorable postoperative outcomes.•The findings highlight the potential of advanced 3D laparoscopy in managing complex renal pathologies, offering a minimally invasive alternative to traditional techniques.

Horseshoe kidney (HSK) and autosomal dominant polycystic kidney disease (ADPKD) are rare congenital anomalies that pose significant surgical challenges.

This is the first reported case of a 3D laparoscopic bilateral nephrectomy in a patient with ADPKD-HSK, incorporating bilateral kidney mobilization.

The 3D laparoscopic approach enhanced surgical precision and depth perception, improving visualization of complex anatomical structures.

This technique optimized anatomical space for future renal transplantation, minimizing operative risks and ensuring favorable postoperative outcomes.

The findings highlight the potential of advanced 3D laparoscopy in managing complex renal pathologies, offering a minimally invasive alternative to traditional techniques.