Cargando…

A totally extraperitoneal approach for endoscopic resection of a congenital prepubic sinus through the pubic symphysis

BACKGROUND: A congenital prepubic sinus (CPS) is a rare congenital anomaly in which a duct remnant extends from the skin opening near the pubic symphysis to various parts and the lesions are mostly located in the preperitoneal space. The totally extraperitoneal (TEP) approach is an operational metho...

Descripción completa

Detalles Bibliográficos
Autores principales: Fukuhara, Masahiro, Onishi, Shun, Yonemura, Yusuke, Sato, Tomoe, Tsutsumi, Satoshi, Bandoh, Toshio, Utsunomiya, Tohru, Esumi, Genshiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8282886/
https://www.ncbi.nlm.nih.gov/pubmed/34264431
http://dx.doi.org/10.1186/s40792-021-01245-0
_version_ 1783723086377385984
author Fukuhara, Masahiro
Onishi, Shun
Yonemura, Yusuke
Sato, Tomoe
Tsutsumi, Satoshi
Bandoh, Toshio
Utsunomiya, Tohru
Esumi, Genshiro
author_facet Fukuhara, Masahiro
Onishi, Shun
Yonemura, Yusuke
Sato, Tomoe
Tsutsumi, Satoshi
Bandoh, Toshio
Utsunomiya, Tohru
Esumi, Genshiro
author_sort Fukuhara, Masahiro
collection PubMed
description BACKGROUND: A congenital prepubic sinus (CPS) is a rare congenital anomaly in which a duct remnant extends from the skin opening near the pubic symphysis to various parts and the lesions are mostly located in the preperitoneal space. The totally extraperitoneal (TEP) approach is an operational method that provides a good field of view for the preperitoneal space. We report the CPS through the pubic symphysis in which complete resection was achieved by a TEP approach. TEP approach was minimally invasive and achieved satisfactory cosmetic outcome. CASE PRESENTATION: We herein report the case of a 13-year-old boy with a fistula opening near the dorsal penis. He was admitted to our hospital due to fever and lower abdominal pain. Abdominal ultrasonography and computed tomography revealed an abscess inside a fistula lumen on the posterior surface of the rectus abdominis muscles in the midline of the lower abdomen. Under a diagnosis of CPS, which was located in the preperitoneal space, endoscopic resection was performed by a totally extraperitoneal approach. After making an umbilical incision, the rectus abdominis muscle was excised outward to expose the preperitoneal space. A single-port system was placed in the preperitoneal space. Three 5-mm-port trocars were inserted. As the preperitoneal cavity was expanded, a sinus connecting to the pubic symphysis was confirmed. The pubic symphysis did not connect with the bladder. Because the fistula was penetrated with the pubic symphysis, the remaining caudal fistula was removed from the body surface with a small spindle-shaped incision around the fistula opening. Finally, the sinus was completely resected, with confirmation from both the cranial side and dorsal side of the pubic symphysis. We were able to perform complete resection of the CPS with good visibility and without any peritoneal damage. There were no intraoperative complications. His postoperative course was uneventful during the 1-year follow-up. CONCLUSIONS: The TEP approach may be feasible for the resection of a CPS and may allow safe and secure resection due to good visibility, even in pediatric patients. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40792-021-01245-0.
format Online
Article
Text
id pubmed-8282886
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Springer Berlin Heidelberg
record_format MEDLINE/PubMed
spelling pubmed-82828862021-07-20 A totally extraperitoneal approach for endoscopic resection of a congenital prepubic sinus through the pubic symphysis Fukuhara, Masahiro Onishi, Shun Yonemura, Yusuke Sato, Tomoe Tsutsumi, Satoshi Bandoh, Toshio Utsunomiya, Tohru Esumi, Genshiro Surg Case Rep Case Report BACKGROUND: A congenital prepubic sinus (CPS) is a rare congenital anomaly in which a duct remnant extends from the skin opening near the pubic symphysis to various parts and the lesions are mostly located in the preperitoneal space. The totally extraperitoneal (TEP) approach is an operational method that provides a good field of view for the preperitoneal space. We report the CPS through the pubic symphysis in which complete resection was achieved by a TEP approach. TEP approach was minimally invasive and achieved satisfactory cosmetic outcome. CASE PRESENTATION: We herein report the case of a 13-year-old boy with a fistula opening near the dorsal penis. He was admitted to our hospital due to fever and lower abdominal pain. Abdominal ultrasonography and computed tomography revealed an abscess inside a fistula lumen on the posterior surface of the rectus abdominis muscles in the midline of the lower abdomen. Under a diagnosis of CPS, which was located in the preperitoneal space, endoscopic resection was performed by a totally extraperitoneal approach. After making an umbilical incision, the rectus abdominis muscle was excised outward to expose the preperitoneal space. A single-port system was placed in the preperitoneal space. Three 5-mm-port trocars were inserted. As the preperitoneal cavity was expanded, a sinus connecting to the pubic symphysis was confirmed. The pubic symphysis did not connect with the bladder. Because the fistula was penetrated with the pubic symphysis, the remaining caudal fistula was removed from the body surface with a small spindle-shaped incision around the fistula opening. Finally, the sinus was completely resected, with confirmation from both the cranial side and dorsal side of the pubic symphysis. We were able to perform complete resection of the CPS with good visibility and without any peritoneal damage. There were no intraoperative complications. His postoperative course was uneventful during the 1-year follow-up. CONCLUSIONS: The TEP approach may be feasible for the resection of a CPS and may allow safe and secure resection due to good visibility, even in pediatric patients. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40792-021-01245-0. Springer Berlin Heidelberg 2021-07-15 /pmc/articles/PMC8282886/ /pubmed/34264431 http://dx.doi.org/10.1186/s40792-021-01245-0 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Case Report
Fukuhara, Masahiro
Onishi, Shun
Yonemura, Yusuke
Sato, Tomoe
Tsutsumi, Satoshi
Bandoh, Toshio
Utsunomiya, Tohru
Esumi, Genshiro
A totally extraperitoneal approach for endoscopic resection of a congenital prepubic sinus through the pubic symphysis
title A totally extraperitoneal approach for endoscopic resection of a congenital prepubic sinus through the pubic symphysis
title_full A totally extraperitoneal approach for endoscopic resection of a congenital prepubic sinus through the pubic symphysis
title_fullStr A totally extraperitoneal approach for endoscopic resection of a congenital prepubic sinus through the pubic symphysis
title_full_unstemmed A totally extraperitoneal approach for endoscopic resection of a congenital prepubic sinus through the pubic symphysis
title_short A totally extraperitoneal approach for endoscopic resection of a congenital prepubic sinus through the pubic symphysis
title_sort totally extraperitoneal approach for endoscopic resection of a congenital prepubic sinus through the pubic symphysis
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8282886/
https://www.ncbi.nlm.nih.gov/pubmed/34264431
http://dx.doi.org/10.1186/s40792-021-01245-0
work_keys_str_mv AT fukuharamasahiro atotallyextraperitonealapproachforendoscopicresectionofacongenitalprepubicsinusthroughthepubicsymphysis
AT onishishun atotallyextraperitonealapproachforendoscopicresectionofacongenitalprepubicsinusthroughthepubicsymphysis
AT yonemurayusuke atotallyextraperitonealapproachforendoscopicresectionofacongenitalprepubicsinusthroughthepubicsymphysis
AT satotomoe atotallyextraperitonealapproachforendoscopicresectionofacongenitalprepubicsinusthroughthepubicsymphysis
AT tsutsumisatoshi atotallyextraperitonealapproachforendoscopicresectionofacongenitalprepubicsinusthroughthepubicsymphysis
AT bandohtoshio atotallyextraperitonealapproachforendoscopicresectionofacongenitalprepubicsinusthroughthepubicsymphysis
AT utsunomiyatohru atotallyextraperitonealapproachforendoscopicresectionofacongenitalprepubicsinusthroughthepubicsymphysis
AT esumigenshiro atotallyextraperitonealapproachforendoscopicresectionofacongenitalprepubicsinusthroughthepubicsymphysis
AT fukuharamasahiro totallyextraperitonealapproachforendoscopicresectionofacongenitalprepubicsinusthroughthepubicsymphysis
AT onishishun totallyextraperitonealapproachforendoscopicresectionofacongenitalprepubicsinusthroughthepubicsymphysis
AT yonemurayusuke totallyextraperitonealapproachforendoscopicresectionofacongenitalprepubicsinusthroughthepubicsymphysis
AT satotomoe totallyextraperitonealapproachforendoscopicresectionofacongenitalprepubicsinusthroughthepubicsymphysis
AT tsutsumisatoshi totallyextraperitonealapproachforendoscopicresectionofacongenitalprepubicsinusthroughthepubicsymphysis
AT bandohtoshio totallyextraperitonealapproachforendoscopicresectionofacongenitalprepubicsinusthroughthepubicsymphysis
AT utsunomiyatohru totallyextraperitonealapproachforendoscopicresectionofacongenitalprepubicsinusthroughthepubicsymphysis
AT esumigenshiro totallyextraperitonealapproachforendoscopicresectionofacongenitalprepubicsinusthroughthepubicsymphysis