Umbilical reconstruction in patients with exstrophy: The kangaroo pouch technique

Purpose: Before the current attitude of umbilical preservation and transpos ition at bladder closure in patients with exstrophy the navel was systemati cally removed. Many patients without an umbilicus complain about this defor mity. We report a simple technique of umbilical reconstruction using a rect angular skin flap fashioned as a kangaroo pouch. Materials and Methods: Four patients 10 to 20 years old with exstrophy unde rwent this procedure. A small cutaneous pouch was fashioned by folding a ve rtical rectangular skin flap and the pouch was anchored deeply to the rectu s fascia. A compressive dressing was packed into the new umbilicus and left in place for several days. Results: The 4 patients have an excellent cosmetic result with adequate loc ation, good morphology and sufficient depth at a mean folIowup of 8 months (range 6 to 11). Conclusions: Our technique of umbilical reconstruction is easy to perform a nd provides good mid-term cosmetic results. This technique is particularly adapted for patients with exstrophy who often require external genital reco nstruction at the same time.