Laparoscopic management of complicated urachal remnants

To report our experience with a laparoscopic approach to managing symptomatic urachal anomalies.

Five patients (median age 19 years, range 2-43) had a laparoscopic excision of a complicated urachal remnant between 2001 and 2004. Three ports were routinely used, although their positioning varied as our technique developed with experience. The urachal remnant was dissected from the umbilicus to the bladder dome and then removed intact.

All five operations had no serious immediate complications and minimal blood loss. One patient developed a small peri-umbilical haematoma after surgery and another had a persistent umbilical discharge at follow-up, and required open excision of residual remnant tissue.

The laparoscopic approach appears to be a safe and effective alternative to open surgery for this condition. Despite the slight risk of incomplete excision, the reduced morbidity of this procedure and better cosmetic result would appear advantageous.