title: Laparoscopic management of complicated urachal remnants in adults.
abstract: OBJECTIVE
  The traditional surgical approach for removing a urachal remnant is via a large transverse or midline infraumbilical incision. We review our experience with laparoscopic urachal cyst excision and report the efficacy and outcomes of this approach as a less morbid, minimally invasive alternative.
  
  
  METHODS
  Between August 2005 and March 2009, eight patients with a mean age of 26 years who had symptomatic urachal cysts underwent laparoscopic radical excision of the urachal remnant. Using three ports, the urachal remnant was dissected from the umbilicus to the bladder dome and then removed intact via the umbilicus. Umbilicoplasty was performed by a plastic surgeon. We retrospectively reviewed the perioperative records to assess morbidity and outcomes.
  
  
  RESULTS
  All eight operations were completed successfully. No intraoperative or postoperative complications were reported at a mean follow-up of 3.2 years. Mean operative time was 147.5 min including umbilicoplasty. Pathological evaluation confirmed a benign urachal remnant in each case. There have been no recurrences of symptoms nor postoperative complications during follow-up. Mean time to full recovery, defined as return to normal life without pain, was 16 days. The patients with bladder cuff resection had a delayed full convalescence (25 vs. 13 days) due to a minimum degree of dysuria.
  
  
  CONCLUSIONS
  A laparoscopic approach with the removal of urachal remnants via the umbilicus appears to be a safe and effective alternative with better cosmesis when compared to an open approach.
authors.affiliation: Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan. motoosh@md.okayama-u.ac.jp
authors.forename: Motoo
authors.initials: M
authors.lastname: Araki
authors.forename: Takashi
authors.initials: T
authors.lastname: Saika
authors.forename: Daiji
authors.initials: D
authors.lastname: Araki
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: Shinya
authors.initials: S
authors.lastname: Uehara
authors.forename: Toyohiko
authors.initials: T
authors.lastname: Watanabe
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Yamada
authors.forename: Yasutomo
authors.initials: Y
authors.lastname: Nasu
authors.forename: Hiromi
authors.initials: H
authors.lastname: Kumon
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D009017:Morbidity; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D014496:Urachal Cyst / Q000453:epidemiology / Q000601:surgery*; D014497:Urachus / Q000002:abnormalities* / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods*; D055815:Young Adult