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Laparoscopic excision of the urachus
T Groot-Wassink1, H Deo, H Charfare
1Department of Surgery, Bedford Hospital, Kempston Road, Bedford, MK42 9DJ, England.
Surgical Endoscopy
|April 6, 2001
Summary
Laparoscopic surgery offers a safe and effective treatment for patent urachus, a congenital anomaly. This minimally invasive approach provides excellent cosmetic results and faster recovery for patients with umbilical sinus or abscess.
Area of Science:
- Pediatric Surgery
- Urology
- Developmental Biology
Background:
- The urachus, a remnant of the allantois, normally obliterates into a fibrous cord.
- Incomplete obliteration can lead to urachal anomalies such as umbilical sinus, fistula, cyst, or abscess.
- Traditional surgical treatment involves open resection via a lower midline incision.
Observation:
- A 14-year-old female presented with a subumbilical abscess, which after drainage, evolved into a sinus communicating with the umbilicus.
- This case represents a patent urachus with associated infraumbilical pathology.
- Histological examination confirmed an epithelial-lined urachus.
Findings:
- Laparoscopic excision of the patent urachus was successfully performed.
- The procedure involved umbilical peritoneal incision, excision of the urachal tract and skin sinus, and ligation of the lower end.
- The patient experienced a swift recovery, with discharge the day after surgery and wound healing within a week.
Implications:
- Laparoscopic excision is a feasible and safe alternative to open surgery for patent urachus.
- This minimally invasive technique offers improved surgical access and superior cosmetic outcomes.
- The study supports the adoption of laparoscopic approaches for managing urachal remnants in pediatric patients.