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Transumbilical versus periumbilical incision for laparoscopic surgery: A meta-analysis
Shen-Liang Shih1, Bo-Han Chen2, Ka-Wai Tam3
1Cancer Center, Yuan's General Hospital, Kaohsiung, Taiwan; Department of Health Business Administration, Meiho University, Pingtung, Taiwan.
American Journal of Surgery
|May 7, 2020
Summary
For laparoscopic abdominal surgery, a transumbilical incision is superior to a periumbilical incision for initial peritoneal access. This method significantly reduces operation time without compromising patient outcomes or safety.
Area of Science:
- Laparoscopic surgery
- Surgical techniques
- Abdominal surgery
Background:
- Debate exists regarding the optimal incision for initial peritoneal access in laparoscopic abdominal surgery.
- Transumbilical and periumbilical incisions are common approaches for umbilical trocar insertion.
Purpose of the Study:
- To compare the efficacy of transumbilical versus periumbilical incisions for initial peritoneal access in laparoscopic abdominal surgery.
- To determine the preferred incision route for the initial umbilical trocar placement.
Main Methods:
- A systematic review and meta-analysis of randomized controlled trials.
- Searched PubMed, Embase, and Cochrane Library databases for studies published before March 2020.
- Utilized a random effects model to calculate pooled effect sizes.
Main Results:
- Five trials involving 783 patients were analyzed.
- Transumbilical incisions significantly reduced operative time (mean difference: -7.73 minutes) compared to periumbilical incisions.
- No significant differences were observed in hospital stay, pain scores, surgical site infection rates, cosmetic satisfaction, or complication rates.
Conclusions:
- Transumbilical incisions offer a time-saving advantage for initial peritoneal access in laparoscopic surgery.
- The study recommends transumbilical incisions for initial peritoneal access due to reduced operation time.
- Transumbilical approach is a safe and effective alternative for laparoscopic abdominal surgery.
