Laparoscopic excision of urachal remnants is a safe and effective alternative to open surgery in children
Takayuki Masuko1, Hiroo Uchida, Hiroshi Kawashima
11 Department of Pediatric Surgery, Saitama Children's Medical Center , Saitama, Japan .
Insights
Laparoscopic excision of urachal remnants in children is a safe and effective procedure with excellent cosmetic outcomes. This minimally invasive approach offers better visualization and avoids recurrence, making it a superior alternative to open surgery.
Area of Science:
- Pediatric Surgery
- Urology
- Minimally Invasive Surgery
Background:
- Infected urachal remnants are uncommon, benign conditions with recurrence and malignant potential.
- Urachal remnants can lead to complications if left untreated.
Purpose of the Study:
- To review the experience with laparoscopic excision of urachal remnants in children.
- To report the efficacy and outcomes of this minimally invasive procedure.
Main Methods:
- Retrospective review of five pediatric patients with urachal remnants.
- Laparoscopic excision using a three-port technique.
- Resection from umbilicus to bladder dome with electrocauterization and ligation.
Main Results:
- All five laparoscopic procedures were completed successfully with no intraoperative or postoperative complications.
- Median follow-up of 16 months showed no symptom recurrence.
- Pathological evaluation confirmed complete resection; good cosmetic results were observed.
Conclusions:
- Laparoscopic resection of urachal remnants in children provides superior anatomical visualization.
- This technique is a safer, more effective, and cosmetically advantageous alternative to open surgery.
Background:
An infected urachal remnant is an uncommon benign condition that usually recurs and has the potential to become malignant. This study aimed to review our experience in laparoscopic excision of urachal remnants and report the efficacy and outcomes of the procedure in children.
Patients And Methods:
Between January 2010 and January 2012, five children with a median age of 35 months presented with urachal remnants at our institute. The data and treatment outcomes of all the patients were retrospectively reviewed. Laparoscopic surgery was performed using three ports, including the umbilical port. In all five children, the urachal remnant was excised from the umbilicus to the bladder dome by electrocauterization, and the stump on the bladder was ligated with endoloop sutures and some absorbable sutures.
Results:
All the five procedures were completed successfully. The median pneumoperitoneum time was 75 minutes. The boundary between the normal bladder wall and the urachal remnant was clearly identified using a laparoscope, allowing excision of the remnant and muscle layer of the bladder wall. No intraoperative or postoperative complications were reported at a median follow-up of 16 months. Complete resection of the urachal remnant was confirmed by pathological evaluation. No symptom recurrences were encountered. Laparoscopic resection had good cosmetic outcomes.
Conclusions:
Laparoscopic resection of urachal remnants in children allows for better anatomical visualization and may be considered as a safer, more effective, and more cosmetically beneficial alternative to open surgery.
