Seven cases of umbilical urachal sinus requiring laparoscopic resection of the umbilical urachal remnant

Abstract

Laparoscopic resection of the umbilical urachal remnant appears to be more efficacious than traditional open excision of the urachal remnant. However, there is the issue of urachal carcinoma, and it is not yet known whether it is better to close the peritoneum after resection. In this paper, the surgical technique and issues related to laparoscopic resection of the umbilical urachal remnant were investigated.
Between March 2009 and February 2012, seven patients underwent a laparoscopic resection of the umbilical urachal remnant. They all had a symptomatic urachal sinus and underwent laparoscopic resection of the umbilical urachal remnant after the urachal sinusitis disappeared. A forward-oblique viewing endoscope was used, and a resection of the urachal remnant in the peritoneal cavity was done using three trocars : a 12-mm trocar at the right mid clavicular line at the height of the umbilicus for the laparoscope, and two 5-mm trocars at the right upper and lower abdomen. The bladder side of the urachal remnant was interrupted twice by intracorporeal knot-tying, and the umbilical side of the urachal remnant was dissected by cutting out a circle in the bottom of the umbilicus ; the peritoneum was closed using a running suture.
Laparoscopic resection of the umbilical urachal remnant was efficacious and should be the standard approach given its benefits vis-a-vis surgical damage and the incision.