Laparoscopic treatment of urachal remnants in children.
OBJECTIVE
Urachal remnants are generally treated with the open method. We evaluated the role of laparoscopy for this anomaly in a consecutive series of 27 children treated during a 12-year period.


METHODS
A total of 27 children with a median age of 4.7 years presented with urachal remnants between 1993 and 2006. Two different laparoscopic approaches were used. In the first 9 children a 5 mm laparoscope was inserted at the umbilicus, with working trocars in the left and right upper abdominal wall. In the remaining patients the laparoscope was placed at the left lower abdominal wall, with working ports placed at the left lower and upper abdomen. The working ports were 2 mm trocars. The urachal remnants were ligated and excised by electrocautery, and the bladder-sided stump was ligated with 2 sutures. No drains were used. The specimen were exteriorized via the umbilicus.


RESULTS
Median operative time was 35 minutes. There were no intraoperative or postoperative complications, and no recurrences. Cosmetic results were excellent.


CONCLUSIONS
The laparoscopic approach for urachal remnants is safe, allows for better visualization of the anatomy and yields a cosmetic result that is superior to the open approach.
Turial
Salmai
S
Department of Pediatric Surgery, University Medical Center Mainz, Mainz, Germany. turial@kinderchir.klinik.uni-mainz.de
Hueckstaedt
Thomas
T
Schier
Felix
F
Fahlenkamp
Dirk
D
D000008:Abdominal Neoplasms / Q000473:pathology / Q000601:surgery; D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome; D014497:Urachus / Q000002:abnormalities* / Q000601:surgery