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Three-flap umbilicoplasty: a novel and preliminary method of laparoendoscopic single-site transumbilical surgical approach for urachal remnants

  • Urology - Original Paper
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Abstract

Purpose

Symptomatic urachal remnants are rare benign anomalies affecting young adults. For these patients, both curative treatment and acceptable postoperative aesthetic outcomes are important. Here, we describe a novel transumbilical approach, using Y-shaped incisions and three-flap umbilicoplasty techniques, to improve repair and aesthetic outcomes.

Materials and methods

The clinical and perioperative data of 16 patients (11 men; median age, 25 years; range 16–46 years) who underwent LESS surgery and three-flap umbilicoplasty (LESS group) between December 2013 and March 2017 were analyzed. For comparison, the perioperative data of those who underwent conventional laparoscopic surgery (CL group) between May 2010 and November 2013 at the same institutions were investigated.

Results

The median operative time of the LESS group was longer than that of the CL group (146.5 vs 107 min; p = 0.009). The estimated blood loss and postoperative hospital stay were not significantly different between the two groups. The two perioperative complications were injury to the transverse colon serosa and minor surgical site infection. Both complications were resolved with appropriate management.

Conclusions

This novel umbilical approach is useful for patients with symptomatic urachal remnants, with the reduction in port-site scarring resulting in good postoperative cosmesis.

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References

  1. Berman SM, Tolia BM, Laor E, Reid RE, Schweizerhof SP, Freed SZ (1988) Urachal remnants in adults. Urology 31(1):17–21

    Article  CAS  PubMed  Google Scholar 

  2. Begg RC (1930) The urachus: its anatomy, histology and development. J Anat 64(Pt 2):170–183

    CAS  PubMed  PubMed Central  Google Scholar 

  3. Blichert-Toft M, Nielsen OV (1971) Diseases of the urachus simulating intra-abdominal disorders. Am J Surg 122(1):123–128

    Article  CAS  PubMed  Google Scholar 

  4. Neufang T, Ludtke F, Lepsien G (1992) Laparoscopic excision of an urachal fistula—a new therapy for a rare disorder. Minim Invasive Ther Allied Technol 1(3):245–249

    Google Scholar 

  5. Patrzyk M, Glitsch A, Schreiber A, von Bernstorff W, Heidecke CD (2010) Single-incision laparoscopic surgery as an option for the laparoscopic resection of an urachal fistula: first description of the surgical technique. Surg Endosc 24(9):2339–2342. doi:10.1007/s00464-010-0922-4

    Article  PubMed  Google Scholar 

  6. Iida T, Kawa G, Takizawa N, Kawabata T, Komai Y, Kinoshita H, Matsuda T (2012) Laparoendoscopic single-site surgery for urachal remnants. Asian J Endosc Surg 5(2):100–102. doi:10.1111/j.1758-5910.2011.00126.x

    Article  CAS  PubMed  Google Scholar 

  7. Sato F, Shin T, Yuki H, Liang M, Ando T, Mori K, Nomura T, Mimata H (2012) Umbilical laparoendoscopic single-site technique for complete excision of urachal remnant. J Laparoendosc Adv Surg Tech A 22(9):899–903. doi:10.1089/lap.2012.0245

    Article  PubMed  Google Scholar 

  8. Kaneko K, Tsuda M (2004) Four-triangular-skin-flap approach to umbilical diseases and laparoscopic umbilical port. J Pediatr Surg 39(9):1404–1407

    Article  PubMed  Google Scholar 

  9. Takasu H, Watanabe Y (2010) Umbilicoplasty with 3 triangular skin flaps and excised diamond-shaped skin flap. J Pediatr Surg 45(10):2041–2044

    Article  PubMed  Google Scholar 

  10. Lesavoy MA, Fan K, Guenther DA, Herrera F, Little JW (2012) The inverted-v chevron umbilicoplasty for breast reconstruction and abdominoplasty. Aesthet Surg J 32(1):110–116

    Article  PubMed  Google Scholar 

  11. Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240(2):205–213

    Article  PubMed  PubMed Central  Google Scholar 

  12. 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(5):647–650. doi:10.1007/s00345-012-0829-x

    Article  PubMed  Google Scholar 

  13. Jeong HJ, Han DY, Kwon WA (2013) Laparoscopic management of complicated urachal remnants. Chonnam Med J 49(1):43–47. doi:10.4068/cmj.2013.49.1.43

    Article  PubMed  PubMed Central  Google Scholar 

  14. Li Destri G, Schillaci 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(9):809–814. doi:10.1089/lap.2011.0155

    Article  PubMed  Google Scholar 

  15. Patrzyk M, Wilhelm L, Ludwig K, Heidecke CD, von Bernstorff W (2013) Improved laparoscopic treatment of symptomatic urachal anomalies. World J Urol 31(6):1475–1481. doi:10.1007/s00345-013-1039-x

    Article  PubMed  Google Scholar 

  16. Siow SL, Mahendran HA, Hardin M (2015) Laparoscopic management of symptomatic urachal remnants in adulthood. Asian J Surg 38(2):85–90. doi:10.1016/j.asjsur.2014.04.009

    Article  PubMed  Google Scholar 

  17. Hong SH, Kim JC, Hwang TK (2007) Laparoscopic partial cystectomy with en bloc resection of the urachus for urachal adenocarcinoma. Int J Urol 14(10):963–965. doi:10.1111/j.1442-2042.2007.01855.x

    Article  PubMed  Google Scholar 

  18. Yanishi M, Kinoshita H, Mishima T, Taniguchi H, Yoshida K, Komai Y, Yasuda K, Watanabe M, Sugi M, Matsuda T (2017) Influence of scars on body image consciousness with respect to gender following laparoendoscopic single-site versus conventional laparoscopic surgery. Scand J Urol 51(1):57–61. doi:10.1080/21681805.2016.1250811

    Article  PubMed  Google Scholar 

  19. Cutting CW, Hindley RG, Poulsen J (2005) Laparoscopic management of complicated urachal remnants. BJU Int 96(9):1417–1421. doi:10.1111/j.1464-410X.2005.05856.x

    Article  PubMed  Google Scholar 

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Correspondence to Hakushi Kim.

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The authors declare that they have no conflict of interest.

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

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

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Kim, H., Nakajima, S., Kawamura, Y. et al. Three-flap umbilicoplasty: a novel and preliminary method of laparoendoscopic single-site transumbilical surgical approach for urachal remnants. Int Urol Nephrol 49, 1965–1971 (2017). https://doi.org/10.1007/s11255-017-1678-8

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  • DOI: https://doi.org/10.1007/s11255-017-1678-8

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