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Improved laparoscopic treatment of symptomatic urachal anomalies

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Abstract

Purpose

Remaining urachal anomalies are seldom found but can result in long-standing recurrent symptoms and repeated surgery. In this single-centre study, we evaluated the laparoscopic approach of excision of the urachus leaving the umbilicus untouched.

Methods

Twenty-one patients were operated on for persisting symptomatic urachal anomalies between 1998 and 2011. Patients included 8 males and 13 females (mean 28.5 years, range 15–72 years). Patients’ histories, surgical data and demographic data were prospectively collected and analysed. During follow-up, patients were evaluated using the total body image and cosmesis questionnaire (BIQ).

Results

Excision of the urachus was carried out in 18 cases in a laparoscopic three-trocar technique and in 3 cases using single-site surgery. In all cases, the infected umbilicus was left untouched. Mean surgical time of all procedures was 55.7 min (31–106 min). Histopathology confirmed an urachal anomaly in all cases. The former discharging or infected umbilicus healed without any complications. Sixteen patients could be included for the BIQ. Total body image score after surgery was 5.49 with a score of 5.0 being the most satisfactory result possible. The total cosmetic score was 21.37 close to the maximum score of 24.

Conclusions

The laparoscopic treatment of urachal anomalies using a three-trocar technique or the single-site surgery technique is both safe and effective. In our opinion, the excision of the umbilicus should be avoided. It simplifies the procedure and leads to satisfactory cosmetic results.

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Conflict of interest

We certify that there are no conflicts of interest, including specific financial interests and relationships and affiliations relevant to the subject matter or materials discussed in the manuscript.

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Author notes

  1. Lutz Wilhelm

    Present address: Department of Surgery, Demmin District Hospital, Demmin, Germany

  2. Kaja Ludwig

    Present address: Department of Surgery, Suedstadt-Klinikum, Rostock, Germany

Authors and Affiliations

  1. Department of General, Visceral, Thoracic and Vascular Surgery, University Medicine, Ernst-Moritz-Arndt-University, Ferdinand-Sauerbruch-Strasse, 17575, Greifswald, Germany

    Maciej Patrzyk, Claus Dieter Heidecke & Wolfram von Bernstorff

Authors
  1. Maciej Patrzyk
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  2. Lutz Wilhelm
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  3. Kaja Ludwig
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  4. Claus Dieter Heidecke
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  5. Wolfram von Bernstorff
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Corresponding author

Correspondence to Maciej Patrzyk.

Additional information

Maciej Patrzyk and Lutz Wilhelm have contributed equally to this work and share first authorship.

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Patrzyk, M., Wilhelm, L., Ludwig, K. et al. Improved laparoscopic treatment of symptomatic urachal anomalies. World J Urol 31, 1475–1481 (2013). https://doi.org/10.1007/s00345-013-1039-x

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  • DOI: https://doi.org/10.1007/s00345-013-1039-x

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