Single-incision laparoscopic surgery as an option for the laparoscopic resection of an urachal fistula: first description of the surgical technique.
BACKGROUND
Persistent urachal sinuses or fistulas are rare but may potentially cause various symptoms and lead to repeated operations. Both laparoscopic and open surgery have been used for the resection of the urachus.


METHODS
This report describes the first case of an external urachal fistula with recurrent infections and discharge of the umbilicus treated by complete resection using single-incision laparoscopic surgery (SILS). This involved a laparoscopic single-incision three-trocar-technique, leaving the infected site of the umbilicus untouched.


RESULTS
Healing of the umbilicus was uneventful and complete. To date, the authors have not seen any recurrence of the fistula or its symptoms.


CONCLUSIONS
Remnants of the urachus should be considered in cases of recurrent infections or discharge of the umbilicus. The SILS procedure is an excellent option for the radical resection of the remnant urachus. Compared with the standard laparoscopic approach, it requires only one incision, decreasing the risks compared with those of several trocars. At the same time, the patient benefits from the better cosmetic result.
Patrzyk
Maciej
M
Department of Surgery, Clinic of General, Visceral, Thoracic, and Vascular Surgery, Ernst-Moritz-Arndt-University Hospital, Greifswald, Germany. patrzyk@uni-greifswald.de
Glitsch
Anne
A
Schreiber
André
A
von Bernstorff
Wolfram
W
Heidecke
Claus-Dieter
CD
D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D012008:Recurrence; D014463:Ultrasonography; D014472:Umbilicus / Q000601:surgery; D014496:Urachal Cyst / Q000000981:diagnostic imaging / Q000601:surgery*; D014497:Urachus / Q000601:surgery; D055815:Young Adult