Abstract

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• Technological advancements have refined laparoscopic surgery and expanded its application to include many disease processes and organs. As next-generation instruments become smaller (<5 mm), secondary benefits such as cosmesis, patient satisfaction, and decreased postoperative analgesic requirements are being realized. Urachal anomalies are rare, and their management is evolving from total radical open, to needlescopic (≤ 3 mm) excision. We present a case of a 25-year-old woman with a symptomatic urachal sinus that was treated with needlescopic instruments. She was discharged within 24 hours of surgery, having had a single intramuscular injection of meperidine and an excellent cosmetic result. A review of the literature reveals that to date 10 urachal anomalies have been excised laparoscopically with no complications. This technique should become the procedure of choice for the management of urachal pathology.