The use of robotically assisted surgery for treating urachal anomalies

Abstract

OBJECTIVE To report the management of urachal anomalies using a robotically assisted approach. PATIENTS AND METHODS Between January 2005 and February 2006, five patients (mean age 51 years, range 24–68) were diagnosed with urachal anomalies. Two basic robot‐assisted surgical approaches were used for excising the urachal anomalies: excision of the urachal remnant via partial cystectomy, and radical cystectomy for excision of urachal adenocarcinoma. RESULTS All five cases were successful and the excised specimens were assessed histologically. The short‐term oncological outcome in the three patients with histologically confirmed moderately differentiated adenocarcinoma showed no evidence of recurrent disease within a median interval of 8 months. Surveillance follow‐up cystoscopy in the patients who had a partial cystectomy showed a well‐healed bladder mucosa with no evidence of recurrence. CONCLUSIONS Radical excision of the urachal tract with partial cystectomy or radical cystectomy using the da Vinci robot is safe, effective and technically feasible.

Robot-assisted laparoscopic management of urachal cysts in adults

“…This is in agreement with the report of Madeb et al [6]. We performed segmentary bladder resection because of evidence indicating communication between the bladder and the urachus.…”

“…Recently, Madeb et al [6] reported their experience of robotically assisted surgery for treating urachal anomalies. They listed a number of advantages that were associated with the use of a robot, namely that it was possible to visualize the region of interest in a three-dimensional fashion, dexterity was improved, ergonomics were excellent, and there was minimal difficulty in performing intracorporeal suturing.…”

“…Thus, it may be safe, effective, and technically feasible to radically excise the urachal tract via partial cystectomy or radical cystectomy by using a robot. However, little has been reported in the literature regarding this possibility [6]. We report herein two cases of urachal cyst in adults that were managed by robot-assisted laparoscopic surgery.…”

Minimally Invasive Approach to Urachal Remnant in Obese Patient

“…Since first application of minimally invasive technique in 1992, we found 90 cases in the literature of successful laparoscopic resection of urachal remnant in adults [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30]. Robotic-assisted approach [11] and single incision laparoscopy [21,22] have been reported with equal to conventional laparoscopy success.…”

“…The persistence of the urachal lumen manifests in several clinical presentations, of which recurrent periumbilical discharge is the most common [9], following by abdominal mass. Very rare other clinical scenarios have been described, including urachal carcinoma [10,11], colo-urachalcutaneous fistula [12] and small bowel obstruction [13]. Diagnosis of the persistent urachal remnant could be challenging and first of all requires a thorough history and physical examination [5].…”