Laparoscopic Management of Urachal Cysts in Adulthood

Cadeddu, Jeffrey A.; Boyle, Karen E.; Fabrizio, Michael D.; Schulam, Peter G.; Kavoussi, Louis R.

doi:10.1016/s0022-5347(05)67020-6

Cited by 74 publications

(13 citation statements)

References 15 publications

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“…We did not observe any symptom recurrence suggestive of incomplete excision during the follow-up period in our series, which agrees with most series of other reports using open traditional or robot-assisted techniques 9,10,19,22-27…”

Section: Discussionsupporting

confidence: 91%

“…Since then, there have been several other case reports of laparoscopic excision of various types of urachal remnants in patients of various ages 15-18. There have also been two very short series of laparoscopic management of urachal remnants, one in four adults19 and one in four children 20. Both of these series used basically the same technique and showed that a laparoscopic technique can be used safely and effectively to remove all urachal remnant tissue with minimal morbidity.…”

Section: Discussionmentioning

confidence: 99%

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Laparoscopic Management of Complicated Urachal Remnants

2013

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Managing persistent and symptomatic urachal anomalies requires wide surgical excision of all anomalous tissue with a cuff of bladder tissue via the open approach. We report 7 cases with complete laparoscopic removal of symptomatic urachal remnants with or without a cuff of bladder tissue. We expected that this technique would be less invasive and have lower morbidity. We report on the feasibility of this approach, including efficacy and outcomes. Eight patients with a mean age of 36.5 years who had symptomatic urachal diseases underwent laparoscopic excision between July 2004 and July 2012. With the use of four ports, the urachal remnant was dissected transperitoneally and then removed via the umbilicus port. The clinical results of laparoscopic urachal remnant excision as a minimally invasive surgery, the perioperative records, and pathologic results were evaluated. There were no intraoperative or postoperative complications. Mean surgery time was 2.7 hours. Mean hospital stay was 14.6 days. The patients with bladder cuff resection had a long admission and Foley catheterization period (mean, 14.4 and 11 days). Pathological evaluations were 6 cases of infected urachal cysts, 1 case of infected urachal sinus, and 1 case of urachal adenocarcinoma. We found no postoperative complications including any symptom recurrence or voiding difficulty during a mean follow-up of 46.3 months. The perioperative surgical outcomes achieved infection control and symptomatic relief and additionally good cosmesis. Complete laparoscopic removal of symptomatic urachal remnants with or without a cuff of bladder tissue seems to be a safe, effective, and better cosmetic alternative with the advantages of a minimally invasive approach.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Laparoscopic Management of Complicated Urachal Remnants

2013

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“…No patient developed local or distant recurrence at a mean follow-up of 6.5 months (range 4.5–9). Laparoscopic partial cystectomy has also been described for urachal cysts, vesical endometriosis, bladder pheochromocytoma, bladder leiomyoma, post-traumatic splenic pseudocyst, bladder schwannoma, and endometrioid adenocarcinoma [ 25 – 31 ].…”

Section: Discussionmentioning

confidence: 99%

Necrotic mass after transurethral resection of a bladder tumor: novel management with robotic partial cystectomy

et al. 2007

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A 76-year-old female with a history of high-grade transitional cell carcinoma (TCC) of the bladder presented with persistent nocturia and urge incontinence and was diagnosed with a necrotic bladder lesion. Cystoscopy revealed a 4 cm area of necrosis, ulceration, calcification, and fat. Transurethral biopsy confirmed the lesion to be benign, and two attempts to re-epithelialize the area of necrosis with cold scraping of exudate failed. Decision was then made to proceed with removal of necrotic lesion with bladder preservation. With the aid of concomitant cystoscopic visualization of the necrotic lesion, a robotic partial cystectomy with bladder reconstruction was performed. The patient tolerated the procedure, had an uneventful post-operative course, and remains asymptomatic and disease-free at last follow-up of 6 months. To our knowledge, this case represents the first report of a necrotic lesion as a complication of transurethral resection of a bladder tumor (TURBT) and the first description of a robotic partial cystectomy for the management of either benign or malignant bladder disease.

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“…En caso de infección del quiste es recomendable realizar drenaje percutáneo del mismo junto con tratamiento antibiótico hasta control de la infección, para, en un segundo tiempo proceder a la extirpación quirúrgica 2,3,5,6 . En la actualidad el abordaje laparoscópico constituye la técnica quirúrgica de elección para el tratamiento del quiste de uraco 8, 10,15,16 .…”

Section: Figuraunclassified