Laparoscopic Excision of Urachal Remnants Is a Safe and Effective Alternative to Open Surgery in Children

MasukoTakayuki,; Uchida, Hiroo; KawashimaHiroshi,; TanakaYujiro,; DeieKyoichi,; IwanakaTadashi,

doi:10.1089/lap.2013.0127

Cited by 13 publications

(4 citation statements)

References 9 publications

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“…As with all laparoscopic procedures, there is the potential for more rapid recovery, improved cosmesis, and less postoperative pain. Although these have not been specifically addressed in our study, Masuko et al felt that the laparoscopic approach offered good cosmetic outcomes [11].…”

Section: Resultsmentioning

confidence: 68%

Laparoscopic vs Open Excision of Urachal Remnants in Children

2014

J Surg

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Introduction: A urachal remnant forms when the allantois fails to completely obliterate. This results in a spectrum of anomalies. It is generally accepted that urachal remnants should be excised. Traditionally, excision has been performed via an open umbilical approach. Recently, minimally invasive techniques have been applied toward the correction of urachal anomalies. However, there are few studies in the literature comparing open and laparoscopic excision in adults and none in children. Materials and methods:We performed a retrospective chart review of all patients undergoing open or laparoscopic excision of a urachal remnant in a single institution from June 2007 to January 2013.Results: There were 4 patients in the laparoscopic group and 10 in the open excision group. There was no difference in age at surgery between the two groups. There was no difference in operative time (laparoscopic: 66.75 min vs open: 57.2 min, p-value 0.50). There was a trend toward increased cost and longer post-operative length of stay in the laparoscopic group ($60594.05 vs $40454.83; 43.25 hours vs 9 hours) but neither was statistically significant (p-values 0.11 and 0.058, respectively). There were no complications in either group. Discussion: Laparoscopic excision of urachal remnants is a safe and effective alternative to open excision. In addition, the laparoscopic approach allows for excellent visualization of the entire urachal tract. Although patients undergoing laparoscopic excision had potentially longer hospital stays, this did not necessarily translate into higher costs.

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Section: Resultsmentioning

confidence: 68%

Laparoscopic vs Open Excision of Urachal Remnants in Children

2014

J Surg

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“…Many reports have indicated that LA had good cosmetic outcomes but did not provide supporting evidence. [9] Our data indicated that the total wound length for OA versus LA was not significantly different.…”

Section: Discussionmentioning

confidence: 72%

Surgical management of urachal remnants in children: open versus laparoscopic approach

Tanaka¹,

Misawa²,

Baba³

et al. 2019

Medicine

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Urachal remnants (UR) represent a failure in the obliteration of the allantois, which connects the bladder to the umbilicus, at birth. Surgical management of UR in children is controversial. The traditional surgical approach involves a semicircular intraumbilical incision or a lower midline laparotomy. Recently, many reports have supported the laparoscopic approach (LA) for removing UR. However, there is a paucity of data comparing the benefits of LA those of the open approach (OA).We retrospectively reviewed all children (aged ≤16 years) with UR who underwent surgical procedures. Age at surgery, sex, operative time, intraoperative or postoperative complications, total wound length, and length of hospital stay length after operation were analyzed.Overall, 30 children aged between 9 months and 16 years (mean 9.0 years) underwent surgical procedures: 15 were treated by OA and 15 were treated by LA. The only statistically significant variable was the operative time. Furthermore, we reanalyzed the age distributions of the older children (aged ≥10 years). In this group, no significant difference in the operative time between OA and LA was observed; however, there was a statistically significant difference in the total wound length.Our review indicated that LA required longer operative time than OA without any cosmetic advantage. However, in older children (aged ≥10 years), the difference in the operative time was not significant; moreover, LA provided greater cosmetic advantage. LA is recommended for older children (aged ≥10 years) because of its cosmetic advantage.

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“…While the management of an asymptomatic urachal remnant is still controversial, surgical excision of a symptomatic lesion is strongly recommended. Even if open surgery has been deemed the mainstay for many years, minimal invasive techniques have been employed being considered a safe, effective alternative with additional advantages of improved anatomical visualization and cosmesis [5,6]. Robotic-assisted laparoscopy for the surgical management in pediatric age of urachal anomalies was firstly Fig.…”

Section: Discussionmentioning

confidence: 99%

Robot-assisted excision of urachal cyst: case report in a child

et al. 2021

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Background The urachus is an embryological structure of the urogenital sinus and allantoid that connects the allantois to the early bladder in fetal life and then remains as the median umbilical ligament connecting the umbilicus to the dome of the bladder. An early laparoscopic procedure could trigger a quiescent urachal remnant to become symptomatic, causing a lesion or infection either during carbon oxide contamination or insufflation or a periumbilical or suprapubic port placement. Case presentation A 15-year-old girl complaining of supra-pubic abdominal pain. About 2 months previously, she had undergone laparoscopic appendectomy for acute appendicitis, and early postoperative period was uneventful. She underwent a robotic-assisted excision of a urachal cyst. Conclusions It has been suggested that early laparoscopic procedures could trigger previously asymptomatic urachal remnants to become symptomatic. Robot-assisted excision of a urachal cyst is a safe, effective alternative to open surgery in children.

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Laparoscopic Excision of Urachal Remnants Is a Safe and Effective Alternative to Open Surgery in Children

Abstract: 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.

Cited by 13 publications

References 9 publications

Laparoscopic vs Open Excision of Urachal Remnants in Children

Laparoscopic vs Open Excision of Urachal Remnants in Children

Surgical management of urachal remnants in children: open versus laparoscopic approach

Robot-assisted excision of urachal cyst: case report in a child

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