Case report demonstrates safe robot-assisted radical nephrectomy in a patient with renal cell carcinoma and an intrathoracic kidney, indicating careful planning is crucial.
Introduction Congenital diaphragmatic hernia (CDH) can result in intrathoracic displacement of the kidney, presenting anatomical challenges for robot‐assisted radical nephrectomy (RARN). Reports of RARN in such cases are scarce. Case Presentation A 56‐year‐old man with a history of right‐sided CDH repair was referred for evaluation of an incidentally discovered right renal mass. Computed tomography revealed two right renal tumors (cT1aN0M0) and cranial displacement of the kidney into the thoracic cavity. Given the possibility of intra‐abdominal adhesions and the retrohepatic location of the kidney, retroperitoneal RARN was selected. An intercostal trocar was used to access the high‐positioned kidney. The renal vessels were safely managed using a Vas Guide, and no complications occurred. Pathology confirmed clear cell renal cell carcinoma (pT1aN0M0). Conclusion RARN can be safely performed in patients with prior CDH repair and intrathoracic renal displacement. Preoperative planning and alternative trocar strategies, such as intercostal placement, are essential for successful outcomes.
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