Periumbilical vs transumbilical laparoscopic incision: A patients' satisfaction-centered randomised trial

Area of Science:

• Minimally Invasive Surgery
• Surgical Techniques
• Patient Outcomes

Background:

• Transumbilical incisions (TUI) and periumbilical incisions (PUI) are used in laparoscopic surgery.
• Previous studies yielded conflicting results on cosmetic satisfaction and operative time.
• The impact of TUI on surgical site infection (SSI) requires further investigation.

Purpose of the Study:

• To compare the outcomes of transumbilical incisions (TUI) versus periumbilical incisions (PUI) in general surgery laparoscopic interventions.
• To evaluate differences in cosmetic satisfaction scores (CSS), operative time (OT), and surgical site infection (SSI) rates.
• To identify factors influencing postoperative cosmetic satisfaction.

Main Methods:

• A controlled trial randomized 56 patients (aged 18-70) into TUI and PUI groups (1:1 ratio).
• Eligible procedures included laparoscopic rectopexy, cholecystectomy, appendectomy, or proctocolectomy.
• Exclusion criteria included BMI >40, prior abdominal surgery, or conversion to open surgery.

Main Results:

• Fifty patients (27 PUI, 23 TUI) provided analyzable data; groups were comparable.
• No significant differences were found in CSS evolution, SSI incidence, or OT between TUI and PUI.
• Patients valuing pre-op umbilicus appearance or with higher pre-op CSS experienced worse post-op CSS decline.

Conclusions:

• Transumbilical incisions (TUI) and periumbilical incisions (PUI) demonstrate comparable outcomes for CSS, OT, and SSI in laparoscopic surgery.
• A minority of patients prioritizing pre-operative umbilical appearance are susceptible to decreased post-operative cosmetic satisfaction.
• Pre-operative cosmetic satisfaction is a predictor of post-operative satisfaction decline.