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Published on: September 27, 2024
A comparison of the periumbilical incision and the intraumbilical incision in laparoscopic appendectomy
Jun Suh Lee1, Tae Ho Hong, Jun Gi Kim
1Department of Surgery, Armed Forces Capital Hospital, Seongnam, Korea.
Purpose:
The intraumbilical incision is being used more frequently, with increasing cases of single incision laparoscopic surgery. Since the umbilicus is deeper than the surrounding wall, it has abundant bacteria. No study has compared the adverse outcomes of periumbilical and intraumbilical incisions. We analyzed the wound complication rates of perforated appendicitis patients according to the types of umbilical incision.
Methods:
A retrospective review was done of 280 patients with perforated appendicitis. One hundred fifty nine patients were treated with the intraumbilical incision, and 121 patients were treated with the periumbilical incision. We compared the perioperative outcomes according to each laparoscopic incision.
Results:
There was no difference in operation time, postoperative hospital stay and analgesic requirement between the two groups. One case in the intraumbilical group (0.6%) and three cases in the periumbilical group (2.5%) developed wound infections. The umbilical complication rate showed no difference.
Conclusion:
The wound complication rate of intraumbilical and periumbilical incisions are not different. Although this retrospective study has inherent limitations, the intraumbilical incision seems to be a safe and feasible alternative for the periumbilical incision that can be easier to perform, with better cosmetic results.
Insights
The intraumbilical incision and periumbilical incision show similar wound complication rates in perforated appendicitis patients. This suggests the intraumbilical approach is a safe alternative with potential cosmetic benefits.
Area of Science:
- Laparoscopic surgery
- Surgical outcomes
- Infection control
Background:
- Single incision laparoscopic surgery (SILS) is increasingly utilized.
- The intraumbilical incision is a common SILS approach.
- The umbilicus harbors bacteria, raising concerns about infection risk.
Purpose of the Study:
- To compare wound complication rates between intraumbilical and periumbilical incisions.
- To evaluate adverse outcomes in perforated appendicitis patients undergoing different umbilical incisions.
- To determine the safety and feasibility of the intraumbilical incision.
Main Methods:
- Retrospective review of 280 patients with perforated appendicitis.
- Comparison of perioperative outcomes between intraumbilical (n=159) and periumbilical (n=121) incision groups.
- Analysis of wound infection rates and other complications.
Main Results:
- No significant differences in operation time, hospital stay, or analgesic needs.
- Low wound infection rates: 0.6% for intraumbilical vs. 2.5% for periumbilical.
- Overall umbilical complication rates were comparable between the two incision types.
Conclusions:
- Intraumbilical and periumbilical incisions demonstrate similar wound complication rates.
- The intraumbilical incision is a safe and feasible alternative.
- Potential advantages include ease of performance and improved cosmetic results.
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