AI Summary & Key Takeaways
AI InsightLaparoscopic approach is an effective and minimal invasive technique to treat of urachal remnants in children.
📌 3 Key Takeaways
Abstract
Urachal remnant is an uncommon congenital anomaly which is caused by the persistence of embryologic communication between the bladder and the umbilicus. The surgical approach to these remnants has been open for years but endoscopic surgery has become more popular because of its better cosmetic results, less postoperative pain and faster returns to daily activities. The aim of this study is to present 17 cases of urachal remnants that were treated by laparoscopic excision. Retrospective review was performed included all patients diagnosed with an urachal remnant (UR) and underwent laparoscopic excision between January 2009 and January 2015. Patient variables included age, gender, presenting symptoms, diagnostic modality, type of urachal remnant, operative time, post-operative complications and follow-up were recorded. Laparoscopic surgery was performed using three ports. The urachal remnant was excised starting from the umbilicus to the bladder dome by cauterization. Stump on the bladder was ligated with endoloop sutures. We identified 17 pediatric patients with an urachal cyst (n=8), urachal diverticulum (n=4), urachal sinus (n=4) and patent urachus (n=1). Median age of the patients was 7 years (5 months-17 years). All patients had symptomatic URs. Abdominal pain (n=8), umbilical discharge (n=6), and umbilical mass (n=3) were presenting symptoms. Ultrasonography confirmed the diagnosis of urachal remnant in all children. Mean operating time was 30 minutes (12-60 minutes). No intraoperative or postoperative complications were reported at a mean follow-up of 28 months. Histopatological examination revealed benign urachal remnant. Laparoscopic excision of urachal remnants is a preferable alternative to traditional open surgery with better postoperative analgesia, cosmetic results and rapid healing. Laparoscopic approach is an effective and minimal invasive technique to treat of urachal remnants in children.