Transumbilical Hidden-Scar High Anterior Resection for Sigmoid Colon Cancer Using GelPOINT^® Through an Umbilical...

Area of Science:

• Minimally Invasive Surgery
• Surgical Oncology
• Plastic Surgery

Background:

• Hidden-scar surgery offers scarless abdominal operations via umbilical incisions.
• Traditional straight umbilical incisions limit fascial opening to 2 cm, hindering complex procedures.
• This limitation impedes instrument triangulation, specimen removal, and anastomosis during gastrectomy and colectomy.

Purpose of the Study:

• To introduce a novel umbilical zigzag skin incision technique for scarless abdominal surgery.
• To overcome the fascial opening limitations of standard transumbilical approaches.
• To report the successful application of this technique in laparoscopic colectomy.

Main Methods:

• Developed an umbilical zigzag skin incision in collaboration with plastic surgeons, achieving a 6-cm fascial and peritoneal opening.
• Utilized GelPOINT device to maintain pneumoperitoneum and facilitate instrument triangulation.
• Performed laparoscopic sigmoidectomy on a 64-year-old female patient for sigmoid colon cancer.

Main Results:

• The umbilical zigzag incision technique successfully facilitated laparoscopic sigmoidectomy, including specimen extraction and anastomosis.
• The GelPOINT device enabled a 6-cm fascial opening, overcoming previous limitations.
• The surgical procedure was completed without complications, with the scar effectively hidden within the umbilicus.

Conclusions:

• The umbilical zigzag skin incision technique, combined with GelPOINT, is a viable approach for scarless laparoscopic surgery.
• This method effectively addresses the technical challenges of limited fascial opening in transumbilical surgery.
• The technique resulted in a virtually hidden scar, improving cosmetic outcomes for patients.