V3-13 ENTIRELY MINIMALLY-INVASIVE MANAGEMENT OF AN INFECTED URACHAL CYST IN THE PEDIATRIC PATIENT

Abstract

You have accessJournal of UrologyPediatrics1 Apr 2014V3-13 ENTIRELY MINIMALLY-INVASIVE MANAGEMENT OF AN INFECTED URACHAL CYST IN THE PEDIATRIC PATIENT Christopher Jaeger and Candace Granberg Christopher JaegerChristopher Jaeger More articles by this author and Candace GranbergCandace Granberg More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1314AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Urachal cysts are the most common urachal anomaly in the pediatric patient population. Minimally-invasive approaches have become increasingly prevalent in management. We present an approach to entirely minimally-invasive management of a case of an infected urachal cyst utilizing percutaneous drainage and subsequent robot-assisted laparoscopic cyst excision. METHODS After initial ultrasound-guided percutaneous drain placement and culture-specific antibiotics, an adolescent male underwent delayed robot-assisted urachal cyst excision and partial cystectomy for an infected urachal cyst. The steps of this approach are demonstrated in this video, including (1) ultrasound-guided percutaneous drain placement; (2) placement of robotic ports; (3) identification of anatomic landmarks; (4) dissection of the urachal cyst and bladder from the anterior abdominal wall; (5) dissection of the cyst from the bladder; (6) removal of cyst with small cystotomy; (7) bladder closure in two layers; and (8) interrogation of closure with bladder distension. No perivesical drain was left. RESULTS The patient was discharged on postoperative day 1. A Foley catheter was left indwelling for three days and removed without need for cystogram. There were no complications and incisions were hidden within the umbilicus and at the level of the Pfannenstiel line, rendering the incisions non-visible when the patient wears a bathing suit. CONCLUSIONS Entirely minimally-invasive management of the pediatric infected urachal cyst including percutaneous drain placement and subsequent delayed robot-assisted laparoscopic urachal cyst excision with bladder cuff removal is simple, safe, and offers excellent cosmesis. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e425 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Christopher Jaeger More articles by this author Candace Granberg More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...