Name of the Procedure:

Excision of Urachal Cyst or Sinus, with or without Umbilical Hernia Repair
Alternative names: Urachus Removal Surgery, Umbilical Hernia Repair with Urachal Excision

Summary

The excision of a urachal cyst or sinus is a surgical procedure to remove a fluid-filled cyst or an abnormal sinus tract connected to the bladder, which can sometimes be accompanied by the repair of an umbilical hernia.

Purpose

This procedure is intended to address issues caused by urachal cysts or sinuses, which can become infected or cause discomfort. Additionally, it may resolve complications arising from an associated umbilical hernia. The goal is to remove the abnormal tissue to prevent further infections or symptoms and, if needed, repair the hernia to strengthen the abdominal wall.

Indications

• Recurrent infections or discharge from the umbilical area
• Pain or discomfort in the region of the cyst or sinus
• Presence of an umbilical hernia causing bulges or discomfort
• Suspected malignancy within the urachal cyst

Preparation

• Patients may be required to fast for several hours before the procedure.
• Preoperative blood tests and imaging studies (e.g., ultrasound, CT scan) may be done to plan the surgery.
• Medication adjustments, especially anticoagulants, may be recommended by the doctor.

Procedure Description

1. The patient is placed under general anesthesia.
2. A surgical incision is made near the umbilical area.
3. The cyst or sinus is carefully dissected and removed, ensuring complete excision to prevent recurrence.
4. If an umbilical hernia is present, the hernia sac is identified, reduced, and the abdominal wall is repaired, often using mesh for reinforcement.
5. The surgical site is closed with sutures or staples and bandaged.

Duration

The procedure typically takes 1 to 2 hours.

Setting

This surgery is usually performed in a hospital or surgical center, often involving an overnight stay or more, depending on recovery.

Personnel

• Surgeon
• Surgical nurses
• Anesthesiologist
• Operating room staff

Risks and Complications

• Infection at the surgical site
• Bleeding or hematoma formation
• Injury to surrounding structures such as the bladder
• Recurrence of the urachal cyst or hernia
• Scarring or adhesions

Benefits

• Relief from pain, discomfort, or recurrent infections
• Prevention of future complications such as abscess formation
• Repair of the abdominal wall to prevent hernia recurrence

Recovery

• Postoperative monitoring in the recovery room
• Pain management typically with prescribed medications
• Instructions to avoid heavy lifting and strenuous activities for several weeks
• Follow-up appointments to monitor healing and remove sutures if necessary

Alternatives

• Antibiotic therapy for infection management without surgery (not a long-term solution)
• Laparoscopic surgery as a minimally invasive alternative
• Observation if the cyst or sinus is asymptomatic

Patient Experience

During the procedure, the patient will be under general anesthesia and will not feel pain. Postoperatively, discomfort is managed with pain medications. Patients may experience some swelling and bruising around the surgical site. A complete recovery generally takes a few weeks, during which time physical activity will need to be limited to ensure proper healing.