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Surgical treatment of abdominal aortic aneurysm associated with horseshoe kidney: symphysiotomy using harmonic focus.

Coexistence of horseshoe kidney and abdominal aortic aneurysm (AAA) is a rare entity that presents a technical challenge to vascular surgeons. How to approach such an AAA with horseshoe kidney and whether to divide the renal isthmus remains a controversial issue. We report here the successful surgical repair of an AAA with horseshoe kidney via the transperitoneal approach with division of the renal isthmus by Harmonic Focus, which allowed easy division of the isthmus without bleeding. Harmonic Focus, a hand-held type of harmonic scalpel, was thus useful in symphysiotomy of the horseshoe kidney.