Hand-assisted laparoscopic pyeloplasty and isthmectomy in a patient with a horseshoe kidney.

We report the laparoscopic management of ureteropelvic junction obstruction in a patient with a horseshoe kidney. We believe this to be the first reported case of isthmectomy performed with the Harmonic Scalpel. Follow-up diuretic renal scan and CT revealed improved drainage and separation of the divided horseshoe kidney.