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01-05-2021 | Incision | Urology - Original Paper

Transumbilical laparoendoscopic single-site surgery versus conventional laparoscopic surgery for patients with symptomatic urachal remnants: an experience with 57 patients

Authors: Hakushi Kim, Kazuya Oda, Takato Uchida, Tatsuo Kano, Soichiro Yuzuriha, Izumi Hanada, Tatsuya Otaki, Satoshi Kuroda, Tatsuya Umemoto, Takahiro Ogawa, Taro Higure, Masayoshi Kawakami, Mayura Nakano, Masahiro Nitta, Masanori Hasegawa, Yoshiaki Kawamura, Sunao Shoji, Hidenori Zakoji, Akira Miyajima

Published in: International Urology and Nephrology | Issue 5/2021

Abstract

Purpose

To evaluate the surgical feasibility and postoperative cosmesis of a novel transumbilical laparoendoscopic single-site (LESS) surgical approach involving Y-shaped incisions and three-flap umbilicoplasty in urachal remnant patients.

Methods

Patients with symptomatic urachal remnants who underwent either conventional laparoscopic surgery (CL group, n = 21) or LESS surgery with Y-shaped incisions and three-flap umbilicoplasty (LESS group, n = 36) between May 2010 and September 2019 were retrospectively assessed. Perioperative factors and postoperative esthetic outcomes were compared between the groups using univariate and multivariate analyses. Esthetic outcomes were assessed using the body image questionnaire consisting of the body image scale (BIS) and the cosmetic scale (CS); a higher score indicated a better outcome.

Results

The median operative time was greater and the insufflation time was shorter in the LESS group than in the CL group. The estimated blood loss and postoperative hospital stay and surgical site infection rate did not differ significantly between the groups. While the BIS score also did not differ significantly between the groups, the CS score was greater in the LESS group than in the CL group. Multivariate analysis revealed that the surgery type (LESS surgery) was an independent predictor of greater postoperative esthetic satisfaction.

Conclusion

Transumbilical LESS surgery with Y-shaped incisions and subsequent three-flap umbilicoplasty is feasible in patients with symptomatic urachal remnants. Regarding postoperative cosmesis, the higher CS score suggests that this technique is superior to CL surgery. Furthermore, the selection of this procedure was an independent predictor of good postoperative esthetic outcomes.

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Title: Transumbilical laparoendoscopic single-site surgery versus conventional laparoscopic surgery for patients with symptomatic urachal remnants: an experience with 57 patients
Authors: Hakushi Kim
Kazuya Oda
Takato Uchida
Tatsuo Kano
Soichiro Yuzuriha
Izumi Hanada
Tatsuya Otaki
Satoshi Kuroda
Tatsuya Umemoto
Takahiro Ogawa
Taro Higure
Masayoshi Kawakami
Mayura Nakano
Masahiro Nitta
Masanori Hasegawa
Yoshiaki Kawamura
Sunao Shoji
Hidenori Zakoji
Akira Miyajima
Publication date: 01-05-2021
Publisher: Springer Netherlands
Keyword: Incision
Published in: International Urology and Nephrology / Issue 5/2021
Print ISSN: 0301-1623
Electronic ISSN: 1573-2584
DOI: https://doi.org/10.1007/s11255-020-02746-x

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