چکیده (انگلیسی):

Background: The traditional surgical approach to the excision of persistent urachal
remnants is a lower midline laparotomy or semicircular infraumbilical incision. The aim
of this study is to report our experience with laparoscopic urachus excision as a minimally invasive
diagnostic and surgical technique.
Methods: This study was a prospective study involving patients who were diagnosed with
persistent urachus and underwent laparoscopic excision. The morbidity, recovery, and outcomes
of surgery were reviewed.
Results: Fourteen patients (8 men) with a mean age of 22.8
6.42 years underwent laparoscopic
excision. All patients presented with discharge from the umbilicus. Although four patients
had no sonographic evidence of a patent urachus, a diagnostic laparoscopy detected
a patent urachus that was excised laparoscopically. One patient required laparoscopic reoperation
for persistent discharge, and one patient presented with bladder injury, which was
repaired via a small Pfannenstiel incision without any morbidity. The mean operative time
was 71.1
0.28 minutes, and the mean duration of hospital stay was 1.3
1.38 days. Pathological
examination confirmed a benign urachal remnant in all cases.
Conclusion: Laparoscopy is a useful alternative for the management of persistent or infected
urachus, especially when its presence is clinically suspected despite the lack of sonographic
evidence. The procedure is associated with low morbidity, although a small risk of bladder
injury exists, particularly in cases of severe active inflammation. Recurrence is uncommon
and was caused by inadequate excision of inflammatory tissue in our series that was easily
managed laparoscopically.