Laparoscopic Umbilical Resection of Urachal Remnants: An Optimal Surgical Method

Abstract Background To date, there is no standard established laparoscopic surgical method for managing urachal remnants because of their rarity, and several questions remain unanswered. This study aimed to determine the optimal 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. 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 optimal method for laparoscopic urachal resection. This method may be recommended for young patients with an abdominal wall thickness of < 2 cm.