Presented by: Tsukasa Masuda
Tokyo Dental College Ichikawa General Hospital

Introduction

Recently, laparoendoscopic single-site surgery (LESS), in which a single incision is used to remove the remnant ureter, has been shown to be useful. In addition, preservation of the peritoneum is important to control infection and reduce invasiveness to the intraperitoneal organs. In this report, we describe a laparoscopic ureteral duct excision using the retroperitoneal approach, including the single incision method, that was performed at our hospital.

Materials

Thirteen patients who underwent laparoscopic ureteral duct excision by the retroperitoneal approach at our hospital from November 2013 to March 2023 were included in the study. We reviewed the surgical outcomes and complications retrospectively. For cases performed with reduced port surgery, we used an articulated instrument because its configuration provides a wide range of movements.

Results

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Among these 13 patients, five underwent conventional laparoscopy (cLap) with three ports, and eight patients underwent LESS through an umbilical port. In all cases, umbilical infections were completely controlled with antibiotics and/or drainage. Regarding our patients’ backgrounds, the mean age was 26.8 (range, 13–36) years, and all cases were male. The mean operative time in the cLap group were 152（range, 111-201） minutes and in the LESS group were 172（range, 135-210）minutes. Although there were variations in operative time among the surgeons, no major intraoperative complications were observed. Moreover, we placed a urethral catheter and it was left in place for 3–5 days after surgery. Because the patients had no complications, such as wound infection, the catheter was removed and they were allowed to be discharged from our hospital in average 5.5 (range, 4-9) days.

Conclusion

The laparoendoscpic surgery for urachal remnant with extraperitoneal approach through an umbilical port was a safe procedure, especially LESS using the single port technique, was an effective procedure with good postoperative cosmetic results.

Funding

None

Co-Authors

Hiroki Ishikawa,
Tokyo Dental College Ichikawa General Hospital

Ryohei Takahashi,
Tokyo Dental College Ichikawa General Hospital

Satoshi Tamaki,
Tokyo Dental College Ichikawa General Hospital

Jun Hagiuda,
Tokyo Dental College Ichikawa General Hospital

Ken Nakagawa,
Tokyo Dental College Ichikawa General Hospital