Reduced-port endo-laparoscopic surgery using umbilical zigzag incision for concomitant operations: A case series

Area of Science:

• Minimally Invasive Surgery
• Surgical Oncology
• Abdominal Surgery

Background:

• Reduced-port surgery is increasingly common but technically challenging.
• The umbilical zigzag incision technique expands fascial access via a single umbilical skin incision.
• This method shows promise for complex laparoscopic procedures.

Purpose of the Study:

• To describe the surgical techniques for concomitant laparoscopic surgery using an umbilical zigzag incision.
• To evaluate the feasibility and benefits of the umbilical zigzag incision in laparoscopic procedures.

Main Methods:

• The umbilical zigzag incision was performed on patients requiring multiple abdominal operations.
• The linea alba and peritoneum were incised, and a wound retractor was inserted to enlarge the fascial opening.
• GelPoint was attached for the laparoscopic procedure.

Main Results:

• The umbilical zigzag incision created a fascial opening up to 6 cm, enhancing trocar triangulation and reducing instrument clashing.
• Central abdominal trocars were usable for most intraperitoneal operations, aiding delicate procedures like lymph node dissection.
• Specimen extraction and anastomosis were facilitated by the adequate fascial opening, with no postoperative complications reported and high patient satisfaction.

Conclusions:

• The umbilical zigzag incision is a feasible approach for laparoscopic surgery.
• This technique is particularly advantageous for concomitant laparoscopic surgeries, offering improved access and outcomes.