The Role of Laparoscopy in the Management of Urachal Anomalies in Children

Objectives Management for urachal anomalies (UAs) is controversial. Although traditional treatment of UAs has been surgical excision, recent literature report also a conservative approach. We reviewed our experience to define the role of laparoscopy in the management of UAs in children.Patients and methods From July 2005 to July 2015, 23 children underwent 24 interventions for the treatment of UAs. In four patients, the technique was a laparoscopic-assisted removal of the anomaly, in two patients a laparoscopic-assisted drainage of an urachal abscess, and a pure laparoscopic technique was started in 17 patients.Results Laparoscopic-assisted removal of the UAs was achieved in five cases. In two cases a laparoscopic-assisted drainage of an urachal abscess was performed. The remaining patients were treated by pure laparoscopic technique. Operative or postoperative complications did not occur. Follow-up ranged from 6 months to 10 years and 6 months.Conclusion The pure laparoscopic approach to UAs appears safe and effective in most urachal remnants. Laparoscopic-assisted excision is an alternative approach that is easier to perform in infants. The decision to remove the UAs must be taken after an accurate informed consent of the parents, especially in cases of asymptomatic anomalies. (C) 2017 Annals of Pediatric Surgery.