[Laparoscopic treatment of urachal remnants].
OBJECTIVE
The urachus is a vestigial obliterated structure derived from the alantois. Failure of this involution process originates patent urachal remnants. Surgery is the treatment of choice as it prevents both recurrence of symptoms and malignant transformation. The purpose of this study is to present our experience in the laparoscopic management of this pathology.


METHODS
Three male patients (mean age 39 years) underwent laparoscopic excision of urachal remnants. Two patients were diagnosed with an asymptomatic cyst and one patient with urachal sinus presenting with umbilical discharge. A three-port technique was used to remove the whole urachus tract from the umbilicus to the bladder dome, together with a small bladder patch.


RESULTS
Mean operating time was 94 min and blood loss was minimal. One patient had small intra-operative bladder rupture, successfully managed with adequate closure. No post-operative complications were observed and all patients were discharged on the second postoperative day. Two years later there was no evidence of recurrence.


CONCLUSIONS
Urachal remnants can be successfully treated by laparoscopic surgery, with advantages in terms of morbidity, recovery and cosmetic outcome. Large number, comparative studies are still needed to definitely establish it as the gold standard treatment.
Servicio de Urología, Hospital de Santo Antonio, Oporto, Portugal. manuelantonielo@gmail.com
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Castanheira de Oliveira
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Vila
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Versos
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Araújo
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Fraga
D000328:Adult; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D014497:Urachus / Q000002:abnormalities* / Q000601:surgery*; D055815:Young Adult