A case of laparoscopic excision of patent urachus

ABSTRACT

Patent urachus is an uncommon congenital anomaly caused by persistence of embryologic communication between bladder and umbilicus. The traditional surgical approach has been open for years but laparoscopic approach has become an effective and minimal invasive technique to treat urachal remnants. A 11 years old child presenting as umbilical discharge was diagnosed with patent urachus and treated by laparoscopic excision. There was no intra or postoperative complications. Patient was discharged on post-operative day 1. The urachus connects the fetal allantois at umbilicus to the dome of bladder. Normally it obliterates and gives rise to median umbilical ligament. Urachus is extraperitoneal and easily viewed during laparoscopic visualization of pelvis. Urachal remnants represent a rare congenital anomaly due to failure in obliteration process. Complete excision is indicated both in case of persistent symptomatic remnants and also when asymptomatic for the associated risk of malignant degeneration. The traditional approach has been open surgery. However, it is associated with increased morbidity and longer convalescence. Reporting our experience, we describe the technique step by step of laparoscopic patent urachus excision as minimally invasive diagnostic and surgical approach in comparison to open surgical approach, with better post-operative analgesia, rapid healing and cosmetic results.