Minimally Invasive LESS for Urachal Remnant
Urachal remnant is the persistence of an embryonic tubular structure that connects the urinary bladder to the allantois. Recent reports suggest that an asymptomatic urachal remnant in children does not require surgical treatment. Children with repeated infection of the urachal remnant, as well as adults with symptomatic urachal abnormalities, should undergo surgical resection. For resecting an urachal remnant, laparoendoscopic single-site surgery via single umbilical incision can provide a better cosmetic outcome compared with conventional multiport laparoscopy. Similar to conventional laparoscopy or open surgery, the umbilical laparoendoscopic single-site surgery should be planned after sufficient management of any preceding infection. Both para- and intraumbilical 2-cm incisions are used for commencing the dissection of the urachal remnant. The proximal part of the urachal remnant should be dissected as far distally as possible with an open surgical procedure, because this part is too close to dissect via the umbilical access site with laparoscopic technique. Using a small single-site platform with three 5-mm ports, an effective counter traction and sharp dissection of the urachal remnant can be performed. To close the bladder wall, horizontal stitching with 2-0 absorbable sutures is recommended. The incised anterior peritoneum is closed with a 3-0 running suture. The umbilical laparoendoscopic single-site surgery is a simple and efficient minimally invasive technique and appears to be ideal for patients with symptomatic urachal remnant.
KeywordsLaparoendoscopic single site surgery Urachal remnant Laparoscopy
No competing financial interests exist.
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