Laparoscopic treatment of urachal remnants in children
Salmai Turial1, Thomas Hueckstaedt, Felix Schier
1Department of Pediatric Surgery, University Medical Center Mainz, Mainz, Germany. turial@kinderchir.klinik.uni-mainz.de
Insights
Laparoscopic surgery for urachal remnants in children is safe and effective. This minimally invasive technique offers excellent cosmetic outcomes compared to traditional open surgery.
Area of Science:
- Pediatric surgery
- Minimally invasive surgery
- Urology
Background:
- Urachal remnants are congenital anomalies of the allantois.
- Traditionally, open surgical excision is the standard treatment for urachal remnants.
- Laparoscopic approaches offer potential advantages in pediatric surgical procedures.
Purpose of the Study:
- To evaluate the efficacy and safety of laparoscopy for treating urachal remnants in children.
- To compare laparoscopic outcomes with historical open surgery data.
Main Methods:
- A consecutive series of 27 children with urachal remnants were treated between 1993 and 2006.
- Two distinct laparoscopic techniques were employed, utilizing small trocars for access.
- Urachal remnants were excised using electrocautery, with the bladder stump secured by sutures.
Main Results:
- The median operative time was 35 minutes.
- No intraoperative or postoperative complications were reported.
- Excellent cosmetic results were achieved with no instances of recurrence.
Conclusions:
- Laparoscopic excision of urachal remnants is a safe and feasible option in pediatric patients.
- The laparoscopic approach provides superior anatomical visualization.
- This method results in better cosmetic outcomes than open surgery.
Purpose:
Urachal remnants are generally treated with the open method. We evaluated the role of laparoscopy for this anomaly in a consecutive series of 27 children treated during a 12-year period.
Materials And Methods:
A total of 27 children with a median age of 4.7 years presented with urachal remnants between 1993 and 2006. Two different laparoscopic approaches were used. In the first 9 children a 5 mm laparoscope was inserted at the umbilicus, with working trocars in the left and right upper abdominal wall. In the remaining patients the laparoscope was placed at the left lower abdominal wall, with working ports placed at the left lower and upper abdomen. The working ports were 2 mm trocars. The urachal remnants were ligated and excised by electrocautery, and the bladder-sided stump was ligated with 2 sutures. No drains were used. The specimen were exteriorized via the umbilicus.
Results:
Median operative time was 35 minutes. There were no intraoperative or postoperative complications, and no recurrences. Cosmetic results were excellent.
Conclusions:
The laparoscopic approach for urachal remnants is safe, allows for better visualization of the anatomy and yields a cosmetic result that is superior to the open approach.
