The umbilical ureter originates from the upper part of the umbilical sac, and the normal position of the bladder should be at the umbilicus during the 7th week of embryonic development. If congenital developmental abnormalities cause impaired closure of the umbilical ureter or if the umbilical ureter is partially reopened later in life, different umbilical ureteral malformations are formed. Umbilical ureteral fistulas and umbilical ureteral cysts are rare congenital malformations of the urinary tract with an incidence of approximately 1/300,000 and are traditionally removed by open surgery.
Since any part of the remaining umbilical ureter can become cancerous and has a high chance of malignancy, umbilical ureteral disease, once diagnosed, should be treated with early surgery, and in cases of co-infection, surgery should be performed as soon as the infection is controlled. In traditional surgery, the umbilical ureter is removed by making a shuttle incision centered on the umbilical fistula and extending the incision downward in the midline to the superior border of the symphysis pubis.
This surgical method has long incision, deep trauma, heavy damage to the body, long hospital stay, serious postoperative umbilical disfigurement, large abdominal scar, poor aesthetic effect, and some patients have psychological impact due to loss of umbilical fossa and obvious scar left on the abdomen.
We use laparoscopic surgery to treat umbilical ureteral fistulas and cysts. With only three to four small 0.5-1.0 cm incisions in the abdomen, the entire umbilical ureter can be completely removed, including laparoscopic removal of the umbilical ureter from the abdominal wall segment and the bladder, and then suturing the incision in the bladder. The surgical protocol we have adopted is ahead of our domestic counterparts, with more complete removal of the umbilical ureter, and the umbilical shape can be preserved without affecting the aesthetics of the umbilicus, almost no bleeding, and the patient recovers quickly after the operation, and the patient receives the most advanced and high-quality medical service.