title: Laparoscopic management of urachal remnants in adulthood.
abstract: BACKGROUND
  The aim of this study was to investigate the outcome of laparoscopic excision of urachal remnants (LUR), and to compare the outcome with that of the traditional open excision of urachal remnants (OUR).
  
  
  METHODS
  Between February 2001 and December 2005, six patients with a mean age of 23.8 years who had a symptomatic urachal sinus underwent radical LUR. Using 12 mm and 5 mm ports, the caudal stump of the urachus was ligated with an absorbable clip and divided. The peritoneal and preperitoneal tissue between the medial umbilical ligaments was dissected free of the transversalis fascia. Dissection was carried out along the preperitoneal plane toward the umbilicus. The cephalic side of the lesion was ligated at the umbilicus with an endo-loop and divided. In addition, four patients who underwent a traditional OUR were included. Peri- and postoperative records were reviewed to assess morbidity, recovery, and outcome.
  
  
  RESULTS
  The operative duration was not significantly shorter for the LUR group than the OUR group, but there was generally a reduction in blood loss (mean 16.5 vs 68.3 mL), an earlier resumption of eating (mean 1.3 vs 2.5 days), and a shorter hospital stay (mean 5.3 vs 10.5 days). There were no intraoperative complications in either the LUR or the OUR group. Mean follow up was 5 (range 4-12) months. There were no postoperative complications.
  
  
  CONCLUSIONS
  The results suggest that LUR can be safely and satisfactorily performed in adulthood.
authors.affiliation: Department of Urology, Kyorin University School of Medicine, Mitaka, Tokyo, Japan. toke@kyorin-u.ac.jp
authors.forename: Takatsugu
authors.initials: T
authors.lastname: Okegawa
authors.forename: Akihiro
authors.initials: A
authors.lastname: Odagane
authors.forename: Kikuo
authors.initials: K
authors.lastname: Nutahara
authors.forename: Eiji
authors.initials: E
authors.lastname: Higashihara
mesh_terms: D015746:Abdominal Pain / Q000209:etiology / Q000601:surgery; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome; D014497:Urachus / Q000002:abnormalities* / Q000601:surgery*