Laparoendoscopic single‐site surgery for urachal remnant with extraperitoneal approach through a suprapubic port

Hoshi, Akio; Chihara, Ichiro; Shiga, Masanobu; Nitta, Satoshi; Nagumo, Yoshiyuki; Sakka, Shotaro; Kojo, Kosuke; Ikeda, Atsushi; Yoshino, Takayuki; Kimura, Tomokazu; Kawahara, Takashi; Kandori, Shuya; Negoro, Hiromitsu; Nishiyama, Hiroyuki

doi:10.1111/ases.13056

Cited by 2 publications

(1 citation statement)

References 25 publications

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“…4 ). Considering cosmetic aspects, the laparoendoscopic single-port surgery may be another suitable option [ 6 , 10 , 11 ]. The third point is infection control before surgery.…”

Section: Discussionmentioning

confidence: 99%

Transperitoneal laparoscopic umbilical resection of urachal remnants: a feasible surgical method

et al. 2023

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Background To date, there is no standard established laparoscopic surgical method for managing urachal remnants because of their rarity, and several questions remain unanswered. Are there any problems for considering the operative indications about patients’ factors for example, body mass index and so on? This study aimed to determine the feasible surgical method for managing urachal remnants and presents the operative outcomes of our cases in relation to the findings from the existing literature. Methods We analyzed the data of 16 patients (7 women and 9 men; age range, 19–48 years) who underwent surgery for urachal remnants between January 2013 and March 2019 at our institution. Results In our cases, all urachal remnants were urachal sinuses, and the primary complaints were umbilical pain and pus discharge. Most of these symptoms were controlled using umbilical drainage and oral antibiotic intake; however, incisional drainage was required in two cases. In all cases, we performed a laparoscopic resection of the urachal remnants; one patient underwent an open conversion due to a very thick abdominal wall. Therefore, “peri-umbilical distanse” was proposed as an index to verify the periumbilical abdominal wall thickness. This index may clear the difficulties of the laparoscopic resection of the urachal remnunts. A postoperative complication—local infection that was treated using re-suturing—was observed in one patient. No adverse events occurred in the other cases. Our method was appropriate because it allowed for complete urachal resection with good cosmetic results, i.e., a small and natural scar appearance. Additionally, if bladder injury occurred, bladder re-suturing was easily possible because of the laparoscopic port’s position. Conclusions We present an feasible method for laparoscopic urachal resection. This method may be recommended for young patients with an peri-umbilical distanse of < 2 cm.

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“…4 ). Considering cosmetic aspects, the laparoendoscopic single-port surgery may be another suitable option [ 6 , 10 , 11 ]. The third point is infection control before surgery.…”

Section: Discussionmentioning

confidence: 99%

Transperitoneal laparoscopic umbilical resection of urachal remnants: a feasible surgical method

et al. 2023

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Laparoendoscopic single‐site surgery for urachal remnant with extraperitoneal approach through a suprapubic port

Hoshi

Chihara

Shiga

et al. 2022

Asian J Endoscop Surgery

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Introduction: No standard procedure has been established for laparoendoscopic single-site surgery for urachal remnants (LESS-U). This study aimed to report the novel surgical techniques and initial outcomes of laparoendoscopic single-site surgery with an extraperitoneal approach through a suprapubic port for urachal remnants (spLESS). Methods: Fifty-five patients (median age, 27 years; range, 15-69 years) who underwent LESS-U were analyzed. To overcome the limitations inherent in the conventional procedure (LESS-U through an umbilical port: uLESS), we modified the port placement and approached via the extraperitoneal space. spLESS is a novel procedure which reduces intestinal damage caused by the extraperitoneal approach and overcomes incomplete resection of the urachal remnant, especially in the bladder dome. Three trocars are inserted into the extraperitoneal space through a suprapubic port in spLESS, and complete resection of the urachal remnant from the umbilicus to the bladder is performed with an appropriate incision line. Patient characteristics and perioperative results were retrospectively collected. Cosmetic outcomes were prospectively evaluated using self-administered questionnaires (body image and photo-series questionnaire).Results: spLESS and uLESS were performed in 43 and 12 patients, respectively. No differences were observed between the perioperative results. The cosmetic outcomes were compared between the groups using body image and photo-series questionnaires. No patient developed major complications; there was no recurrence in either group.Conclusions: spLESS is a novel procedure which can completely resect the urachal remnant and reduce the risk of intestinal damage. spLESS is a safe, effective, and feasible procedure with high postoperative cosmesis.

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Laparoendoscopic single‐site surgery for urachal remnant with extraperitoneal approach through a suprapubic port

Cited by 2 publications

References 25 publications

Transperitoneal laparoscopic umbilical resection of urachal remnants: a feasible surgical method

Transperitoneal laparoscopic umbilical resection of urachal remnants: a feasible surgical method

Laparoendoscopic single‐site surgery for urachal remnant with extraperitoneal approach through a suprapubic port

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