張珝¹、陳俐臻¹、陳建志¹、林文榮¹、邱文祥¹

¹馬偕紀念醫院 泌尿科；馬偕醫學院；²國立陽明大學

Syu Jhang¹, Li-Chen Chen¹, Marcelo Chen¹, Wun-Rong Lin¹, Allen W. Chiu^{1, 2}

¹Department of Urology, Mackay Memorial Hospital; Mackay Medical College, Taipei, Taiwan;

²School of Medicine, National Yang-Ming University, Taipei, Taiwan

 

Purpose: Urachal cysts are secondary to incomplete obliteration of the embryonic urachal duct. There were a variety of different surgical approaches to excise urachal cyst. Only few cases were performed by single port excision. We therefore present our method to treat an incidentally found urachal cyst with single port laparoscopic excision.

Case report: A 37-year-old healthy male was incidentally found to have a bladder tumor. Computer tomography revealed a 2.1-cm cystic lesion abutting the dome of urinary bladder with some linear calcification on the bladder wall. Fiberocystocopy showed a cystic tumor in the dome of urinary bladder. He received single port laparoscopic excision of the tumor. We made a 4-cm single incision (2 cm on supra-umbilical area and 2 cm on peri-umbilical area) for LAGIPORT^TM. Three trocars were inserted; two for 5mm instruments and one for 0-degree camera. For wound closure, we used 3-0 V-Loc^TM for muscle layer of bladder, 1-0 Safil^® for peritoneum and subcutaneous layer and 3-0 Nylon for skin. The procedure was completed safely and smoothly. Estimated blood loss was 20 ml. The pathologic finding showed a cystic lesion filled with mucus-like material and few dystrophic calcification fragment without lining cells, compatible with an urachal cyst. There was no any complications after the surgery.

Conclusion: The treatment of choice of urachal cysts is complete excision due to the risk of malignant transformation. Different surgical access for removal of urachal cysts has been described. Laparoscopic excision of urachal cysts has widely been applied in recent years. Compared to conventional laparoscopic surgery, single incision laparoscopic surgery represents a less invasive access, providing the benefit of fewer scars, less pain and shorter recovery periods. This approach is a safe and feasible option for urachal cysts.