Advertisement

International Urology and Nephrology

, Volume 50, Issue 12, pp 2167–2172 | Cite as

Outcomes of laparoscopic resection of urachal remnants followed by novel umbilicoplasty

  • Hiroshi Sasaki
  • Shoji Kimura
  • Hayato Shimada
  • Masaya Murakami
  • Takahumi Yanagisawa
  • Mahito Atsuta
  • Taishi Matsuura
  • Youko Yokawa
  • Katsuhiro Ishida
  • Shin Egawa
Urology - Original Paper
  • 54 Downloads

Abstract

Objective

The purpose of the study was to report the outcomes of our modified techniques of laparoscopic urachal resection, followed by novel umbilical-plasty using dermal regenerative grafts for symptomatic urachal remnants.

Methods

Between March 2014 and December 2016, laparoscopic urachal resection was carried out on 45 patients with complaints of urachal remnants. After extraction of the specimen and closure of the fascia at the umbilical site, a 1-cm square section of dermal regeneration sheet (TERUDERMIS®, Olympus) was suture retained between the fascia and the skin. Patient satisfaction with cosmesis was scored prospectively using the visual analogue scale (VAS). Perioperative records were reviewed to assess surgical outcomes.

Results

Laparoscopic urachal resection was successfully conducted via the transperitoneal approach. Postoperative bleeding was experienced in one patient (2.2%), which was subsequently controlled laparoscopically. Infection subsided with symptomatic relief in all patients. No symptomatic recurrences were encountered. Over 80% of patients (37/45) rated the cosmetic outcome of the plasty as good to excellent, with the median scores of 8 (range 5–10).

Conclusions

Laparoscopic urachal resection is safe and curative with reasonable risk of complications. Novel umbilicoplasty using dermal regenerative graft is very simple technique and offers satisfactory cosmetic outcomes. Further follow-up and cosmesis evaluation are required.

Keywords

Laparoscopic surgery Urachal remnant Umbilicoplasty Dermal regeneration sheet 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Hammond G, Yglesis L, David JE (1941) The urachus, its anatomy and associated fasciae. Anat Rec 80:271–287CrossRefGoogle Scholar
  2. 2.
    Blichert-Toft M, Nielsen OV (1971) Diseases of the urachus simulating intra-abdominal disorders. Am J Surg 122:123–128CrossRefGoogle Scholar
  3. 3.
    Castillo OA, Vitagliano G, Olivares R, Sanchez-Salas R (2007) Complete excision of urachal cyst by laparoscopic means: a new approach to an uncommon disorder. Arch Esp Urol 60:607–611PubMedGoogle Scholar
  4. 4.
    Gopalan A, Sharp DS, Fine SW, Tickoo SK, Herr HW, Reuter VE, Olgac S (2009) Urachal carcinoma: a clinicopathologic analysis of 24 cases with outcome correlation. Am J Surg Pathol 33:659–668CrossRefGoogle Scholar
  5. 5.
    Trondsen E, Reiertsen O, Rosseland AR (1993) Laparoscopic excision of urachal sinus. Eur J Surg 159:127–128PubMedGoogle Scholar
  6. 6.
    Cadeddu JA, Boyle KE, Fabrizio MD, Schulam PG, Kavoussi LR (2000) Laparoscopic management of urachal cysts in adulthood. J Urol 164:1526–1528CrossRefGoogle Scholar
  7. 7.
    Cutting CW, Hindley RG, Poulsen J (2005) Laparoscopic management of complicated urachal remnants. BJU Int 96:1417–1421CrossRefGoogle Scholar
  8. 8.
    Okegawa T, Odagane A, Nutahara K, Higashihara E (2006) Laparoscopic management of urachal remnants in adulthood. Int J Urol 13:1466–1469CrossRefGoogle Scholar
  9. 9.
    Li Destri G, Scillaci D, Latino R, Castaing M, Scilletta B, Cataldo AD (2011) The urachal pathology with umbilical manifestation: overview of laparoscopic technique. J Laparoendosc Adv Surg Tech A 21:809–814CrossRefGoogle Scholar
  10. 10.
    Araki M, Saika T, Araki D, Kobayashi Y, Uehara S, Watanabe T, Yamada K, Nasu Y, Kumon H (2012) Laparoscopic management of complicated urachal remnants in adults. World J Urol 30:647–650CrossRefGoogle Scholar
  11. 11.
    Patrzyk M, Wilhelm L, Ludwig K, Heidecke CD, von Bernstorff W (2013) Improved laparoscopic treatment of symptomatic urachal anomalies. World J Urol 31:1475–1481CrossRefGoogle Scholar
  12. 12.
    Jeong HJ, Han DY, Kwon WA (2013) Laparoscopic management of complicated urachal remnants. Chonnam Med J 49:43–47CrossRefGoogle Scholar
  13. 13.
    Siow SL, Mahendran HA, Hardin M (2015) Laparoscopic management of symptomatic urachal remnants in adulthood. Asian J Surg 38:85–90CrossRefGoogle Scholar
  14. 14.
    Rivera M, Granberg CF, Tollefson MK (2015) Robotic-assisted laparoscopic surgery of urachal anomalies: a single-center experience. J Laparoendosc Adv Surg Tech A 25:291–294CrossRefGoogle Scholar
  15. 15.
    Fode M, Pedersen GL, Azawi N (2016) Symptomatic urachal remnants: case series with results of a robot-assisted laparoscopic approach with primary umbilicoplasty. Scand J Urol 50:463–467CrossRefGoogle Scholar
  16. 16.
    Ortiz Sánchez L, Alonso Prieto MA, Campanario Pérez F, Alvarez-Silva I, De Cabo Ripoll M, García Díez F (2017) Treatment of urachal disorders: the open and laparoscopic surgery approach. Arch Esp Urol 70:357–360PubMedGoogle Scholar
  17. 17.
    Kim H, Nakajima S, Kawamura Y, Shoji S, Hoshi A, Uchida T, Terachi T, Miyajima A (2017) Three-flap umbilicoplasty: a novel and preliminary method of laparoendoscopic single-site transumbilical surgical approach for urachal remnants. Int Urol Nephrol 49(11):1965–1971CrossRefGoogle Scholar
  18. 18.
    Stokes RB, Whetzel TP, Sommerhaug E, Saunders CJ (1998) Arterial vascular anatomy of the umbilicus. Plast Reconstr Surg 102:761–764CrossRefGoogle Scholar
  19. 19.
    Schaefer IM, Seeliger S, Strauss A, Füzesi L, Ringert RH, Loertzer H (2012) A three-step technique for umbilicoplasty in a patent urachus. BJU Int 109(4):640–644CrossRefGoogle Scholar
  20. 20.
    Joseph WJ, Sinno S, Brownstone ND, Mirrer J, Thanik VD (2016) Creating the perfect umbilicus: a systematic review of recent literature. Aesthetic Plast Surg 40(3):372–379CrossRefGoogle Scholar

Copyright information

© Springer Nature B.V. 2018

Authors and Affiliations

  • Hiroshi Sasaki
    • 1
  • Shoji Kimura
    • 1
  • Hayato Shimada
    • 1
  • Masaya Murakami
    • 1
  • Takahumi Yanagisawa
    • 1
  • Mahito Atsuta
    • 1
  • Taishi Matsuura
    • 1
  • Youko Yokawa
    • 2
  • Katsuhiro Ishida
    • 2
  • Shin Egawa
    • 1
  1. 1.Department of UrologyJikei University School of MedicineTokyoJapan
  2. 2.Department of Plastic SurgeryJikei University School of MedicineTokyoJapan

Personalised recommendations