title: Improved laparoscopic treatment of symptomatic urachal anomalies.
abstract: OBJECTIVE
  Remaining urachal anomalies are seldom found but can result in long-standing recurrent symptoms and repeated surgery. In this single-centre study, we evaluated the laparoscopic approach of excision of the urachus leaving the umbilicus untouched.
  
  
  METHODS
  Twenty-one patients were operated on for persisting symptomatic urachal anomalies between 1998 and 2011. Patients included 8 males and 13 females (mean 28.5 years, range 15-72 years). Patients' histories, surgical data and demographic data were prospectively collected and analysed. During follow-up, patients were evaluated using the total body image and cosmesis questionnaire (BIQ).
  
  
  RESULTS
  Excision of the urachus was carried out in 18 cases in a laparoscopic three-trocar technique and in 3 cases using single-site surgery. In all cases, the infected umbilicus was left untouched. Mean surgical time of all procedures was 55.7 min (31-106 min). Histopathology confirmed an urachal anomaly in all cases. The former discharging or infected umbilicus healed without any complications. Sixteen patients could be included for the BIQ. Total body image score after surgery was 5.49 with a score of 5.0 being the most satisfactory result possible. The total cosmetic score was 21.37 close to the maximum score of 24.
  
  
  CONCLUSIONS
  The laparoscopic treatment of urachal anomalies using a three-trocar technique or the single-site surgery technique is both safe and effective. In our opinion, the excision of the umbilicus should be avoided. It simplifies the procedure and leads to satisfactory cosmetic results.
authors: Department of General, Visceral, Thoracic and Vascular Surgery, University Medicine, Ernst-Moritz-Arndt-University, Ferdinand-Sauerbruch-Strasse, 17575, Greifswald, Germany, patrzyk@uni-greifswald.de.
authors: Maciej
authors: M
authors: Patrzyk
authors: Lutz
authors: L
authors: Wilhelm
authors: Kaja
authors: K
authors: Ludwig
authors: Claus Dieter
authors: CD
authors: Heidecke
authors: Wolfram
authors: W
authors: von Bernstorff
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001828:Body Image; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014472:Umbilicus / Q000601:surgery; D014497:Urachus / Q000002:abnormalities* / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods*; D055815:Young Adult