Symptomatic urachal remnants: Case series with results of a robot-assisted laparoscopic approach with primary umbilicoplasty

Fode, Mikkel; Pedersen, Gyrithe Lynghøj; Azawi, Nessn

doi:10.1080/21681805.2016.1221852

Cited by 8 publications

(7 citation statements)

References 15 publications

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“…A procedure in which the urachal remnant is dissected from the umbilicus to the bladder dome and then removed intact via the umbilicus, which is followed by umbilicoplasty, has been described as the proper method for complete resolution of related symptoms, whether it is a laparoscopic approach or open way. [ 8 , 9 ] In our study, we demonstrated the innovative approach of umbilicus-sparing laparoscopic urachal remnant excision and did not perform an umbilectomy. The postoperative periumbilical discharge improved immediately in this study, and long-term follow-up results revealed that no patients had symptomatic recurrence or malignant transformation.…”

Section: Discussionmentioning

confidence: 90%

“…Technical advancements and growing experience make the laparoscopic excision of urachal cysts a simple procedure, allowing for better outcomes. Several studies using laparoscopic excision [ 6 , 8 , 12 , 14 – 16 ] or robot-assisted laparoscopic excision [ 9 , 17 , 18 ] of urachal cysts have been reported. However, the necessary extent of resection remains elusive.…”

Section: Discussionmentioning

confidence: 99%

“…En bloc umbilical resection followed by umbilicoplasty and routine resection of a bladder cuff have been described by several groups as good methods. [ 8 , 9 ] Our research objectives include determining whether umbilicus-reserved and selective excision of a bladder cuff achieves superior cosmetic results and more rapid recovery of patients.…”

Section: Introductionmentioning

confidence: 99%

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Umbilicus-sparing laparoscopic versus open approach for treating symptomatic urachal remnants in adults

Liu

Xiang²,

Hu³

et al. 2018

Medicine

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The traditional surgical approach for removing a symptomatic urachal remnant is via a lower midline laparotomy and infraumbilical incision or a laparoscopic approach with umbilicoplasty. We reviewed our experience with umbilicus-sparing laparoscopic urachal remnant excision in a single-center study and evaluated its efficacy versus open approach (OA). This study was a retrospective study. Between March 2012 and September 2016, 32 consecutive patients with symptomatic urachal remnants underwent the umbilicus-sparing laparoscopic approach (USLA) (n = 17) or OA (n = 15). The efficacy, recovery, and long-term outcomes were reviewed. Our Results showed that the clinical characteristics of the patients in each group, such as age, gender, body mass index (BMI), and disease type, had no significant differences (P > .05). No significant difference was found in the surgical procedure times (76.1 ± 15.4 vs 69.2 ± 13.9 minutes, P = .189) and intraoperative blood loss (29.4 ± 13.3 vs 32.2 ± 12.9 mL, P = .543) between the USLA groups and OA groups. However, the mean postoperative hospital stay (patients with bladder cuff excision: 4.1 ± 1.8 vs 6.1 ± 1.4 days, P = .040 and patients without bladder cuff excision: 1.8 ± 0.5 vs 3.6 ± 0.8 days, P < .001) and the time of full recovery (11.2 ± 1.9 vs 15.6 ± 3.1 days, P < .001), the USLA group were both significantly shorter than that of the OA group. No infected recurrence and malignant transformation had occurred at a mean follow-up of 32.4 ± 8.1 and 34.1 ± 8.8 months in USLA group and OA group, respectively. In conclusion, to minimize the morbidity of radical excision, umbilicus-sparing management of benign urachal remnants in adults is a safe and efficacious alternative with superior cosmetic outcomes, postoperative recovery compared with an OA or umbilicoplasty.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Umbilicus-sparing laparoscopic versus open approach for treating symptomatic urachal remnants in adults

Liu

Xiang²,

Hu³

et al. 2018

Medicine

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“…Surgical excision is indicated for symptomatic urachal remnants [42]. According to a retrospective clinical study from Gleason et al, 54 out of 721 patients (7.29%) with urachal remnants were symptomatic [1].…”

Section: Treatment Strategiesmentioning

confidence: 99%

Urachal remnants: from embryology to clinical practice

Gkalonaki,

Patoulias,

Anastasakis

et al. 2024

Folia Medica Cracoviensia

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The urachus is a tubular structure that is apparent on the third week and connects the ventral cloaca to the yolk sac, as a progression from the allantois. Following the normal regression procedure, the urachus remains as the median umbilical ligament. Urachal remnants are present in 1.03% of paediatric patients while in 92.5% of cases represent incidental findings. Urachal anomalies are classified in four types as patent urachus (50–52%), urachal sinus (15%), urachal cyst (30%) and urachal diverticulum (3–5%). Ultrasound scan is the most commonly performed diagnostic imaging study. In case of symptomatic urachal remnants, surgical excision is indicated. Asymptomatic urachal remnants that are diagnosed at the neonatal period or early infancy should be watched up to 6 months of age, as they are likely to resolve. In persistent or symptomatic urachal remnants there is a risk of inflammation or even malignancy development, therefore we believe that there is indication for preventive surgical excision that may be performed either open or laparoscopically or by robot-assisted laparoscopy.

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“…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 [1][2][3]. Abnormalities in involution of the urachus may result in patent urachus, umbilical urachal sinus, vesico-urachal diverticulum, and urachal cyst [1].…”

Section: Introductionmentioning

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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Symptomatic urachal remnants: Case series with results of a robot-assisted laparoscopic approach with primary umbilicoplasty

Abstract: Based on these findings, it would be reasonable to offer surgery to patients with symptomatic urachal remnants. However, one should be aware that there is a significant risk of complications and that the risk of cancer seems to be limited.

Cited by 8 publications

References 15 publications

Umbilicus-sparing laparoscopic versus open approach for treating symptomatic urachal remnants in adults

Umbilicus-sparing laparoscopic versus open approach for treating symptomatic urachal remnants in adults

Urachal remnants: from embryology to clinical practice

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

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