Introduction: Urachal remnants are relatively rare. Generally, urachal remnants are detected in young people, and the removed specimen is small, comprising a good indication for laparoscopic surgery. Laparoendoscopic single-site surgery (LESS) for urachal remnants is considered to be safe and result in an excellent cosmetic outcome. Therefore, we report our single-center experience with LESS for urachal remnants. Methods: We retrospectively reviewed 30 patients with urachal remnants who underwent LESS from January 2011 to December 2017. The patients’ characteristics, surgical data, postoperative pain, and cosmetic assessment results were retrospectively collected and analyzed. Results: Mean total operative time was 151 min, mean pneumoperitoneal surgery time was 83 min, and mean estimated blood loss was 5.0 mL. All patients were started on an oral diet and began ambulating on postoperative day 1. Mean hospital stay was 5.5 days. LESS was completed successfully in all patients, with no conversion to conventional or open surgery. Conclusions: LESS is a viable option for the surgical treatment of urachal remnants. This technique may result in less pain than conventional techniques. Further accumulation of surgical outcomes (especially regarding safety and cosmesis) is required for LESS to become an established treatment for urachal remnants.

Keywords:
Clinical experience, Cosmesis, Laparoendoscopic single-site surgery, Pain, Urachal remnant
1.
Sheldon CA, Clayman RV, Gonzalez R, Williams RD, Fraley EE. Malignant urachal lesions.
J Urol
. 1984 Jan;131(1):1–8.
2.
Blichert-Toft M, Nielsen OV. Diseases of the urachus simulating intra-abdominal disorders.
Am J Surg
. 1971 Jul;122(1):123–8.
3.
Bauer SB, Retik AB. Urachal anomalies and related umbilical disorders.
Urol Clin North Am
. 1978 Feb;5(1):195–211.
4.
Trondsen E, Reiertsen O, Rosseland AR. Laparoscopic excision of urachal sinus.
Eur J Surg
. 1993 Feb;159(2):127–8.
5.
Matsuda T. Recent advances in urologic laparoscopic surgeries: laparoendoscopic single-site surgery, natural orifice transluminal endoscopic surgery, robotics and navigation.
Asian J Endosc Surg
. 2013 May;6(2):68–77.
6.
Patrzyk M, Glitsch A, Schreiber A, von Bernstorff W, Heidecke CD. Single-incision laparoscopic surgery as an option for the laparoscopic resection of an urachal fistula: first description of the surgical technique.
Surg Endosc
. 2010 Sep;24(9):2339–42.
7.
Iida T, Kawa G, Takizawa N, Kawabata T, Komai Y, Kinoshita H, et al. Laparoendoscopic single-site surgery for urachal remnants.
Asian J Endosc Surg
. 2012 May;5(2):100–2.
8.
Yanishi M, Kinoshita H, Yoshida T, Taniguchi H, Yoshida K, Mishima T, et al. Laparoendoscopic single-site surgery for treatment of urachal remnants.
Can J Urol
. 2017 Dec;24(6):9098–102.
9.
Pust A, Ovenbeck R, Erbersdobler A, Dieckmann KP. Laparoscopic management of patent urachus in an adult man.
Urol Int
. 2007;79(2):184–6.
10.
Kim H, Nakajima S, Kawamura Y, Shoji S, Hoshi A, Uchida T, et al. Three-flap umbilicoplasty: a novel and preliminary method of laparoendoscopic single-site transumbilical surgical approach for urachal remnants.
Int Urol Nephrol
. 2017 Nov;49(11):1965–71.
11.
Sato F, Shin T, Yuki H, Liang M, Ando T, Mori K, et al. Umbilical laparoendoscopic single-site technique for complete excision of urachal remnant.
J Laparoendosc Adv Surg Tech A
. 2012 Nov;22(9):899–903.
12.
Fan X, Lin T, Xu K, Yin Z, Huang H, Dong W, et al. Laparoendoscopic single-site nephrectomy compared with conventional laparoscopic nephrectomy: a systematic review and meta-analysis of comparative studies.
Eur Urol
. 2012 Oct;62(4):601–12.
13.
Antonelli JA, Bagrodia A, Odom C, Olweny EO, Faddegon S, Cadeddu JA. Laparoendoscopic single-site nephrectomy compared with conventional laparoscopic nephrectomy: a 5-year, single-surgeon experience.
Eur Urol
. 2013 Sep;64(3):412–8.
14.
Wang L, Liu B, Wu Z, Yang Q, Chen W, Xu Z, et al. A matched-pair comparison of laparoendoscopic single-site surgery and standard laparoscopic radical nephrectomy by a single urologist.
J Endourol
. 2012 Jun;26(6):676–81.
15.
Yanishi M, Kinoshita H, Mishima T, Taniguchi H, Yoshida K, Komai Y, et al. Influence of scars on body image consciousness with respect to gender following laparoendoscopic single-site versus conventional laparoscopic surgery.
Scand J Urol
. 2017 Feb;51(1):57–61.
© 2019 S. Karger AG, Basel
2019
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.