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The umbilicus in laparoscopic surgery.

A J Voitk1, S G Tsao

  • 1Department of Surgery, The Scarborough Hospital, Grace Division, Scarborough, Ontario, Canada. avoitk@healthwest.nf.ca

Surgical Endoscopy
|July 10, 2001
PubMed
Summary
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Umbilical laparoscopic sites show similar wound infection rates to remote sites, except after cholecystectomy. Postoperative ventral hernias at the umbilicus are also comparable to other sites.

Area of Science:

  • Surgical site infections
  • Minimally invasive surgery outcomes
  • Abdominal wall reconstruction

Background:

  • Laparoscopic surgery frequently utilizes umbilical access.
  • Concerns exist regarding infection and herniation at umbilical sites.
  • Comparison with remote sites is crucial for understanding risks.

Purpose of the Study:

  • To compare infection and incisional herniation rates at umbilical laparoscopic sites versus remote sites.
  • To identify factors influencing these outcomes.
  • To inform surgical practice regarding port site selection.

Main Methods:

  • Prospective analysis of 873 Hasson cannula sites, 748 umbilical sites, and 125 remote sites.
  • Data derived from 561 cholecystectomies, 190 inguinal hernia repairs, 71 Nissen fundoplications, and 51 ventral hernia repairs.

Related Experiment Videos

  • Infection and hernia rates were meticulously recorded and compared.

    • Main Results:

    • Overall wound infection rate was 6%, with 7% at the umbilicus (higher after cholecystectomy) and 0% at remote sites.
    • Excluding cholecystectomy, umbilical infection rate (2%) was similar to remote sites.
    • Postoperative ventral hernia rate was 0.8%, consistent across umbilical and remote sites, correlating with infection but not fascial defects.

    Conclusions:

    • Umbilical wound infection rates are comparable to remote sites, barring cholecystectomy procedures.
    • Postoperative ventral hernias at the umbilicus do not appear related to pre-existing fascial defects.
    • These findings support the safety of umbilical port sites in most laparoscopic procedures.