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Related Concept Videos

Appendicitis-I: Introduction01:22

Appendicitis-I: Introduction

640
The appendix, a small, narrow, blind tube extending from the inferior part of the cecum, is widely regarded as a vestigial organ, having lost much of its original function through evolution. Despite its diminished role, the appendix can become inflamed, a condition known as appendicitis.
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
640

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Updated: Sep 15, 2025

Application of Straight-needle, Three-tailed, Knot-free, Peritoneal Sutures in Laparoscopic Transabdominal Preperitoneal Hernia Repair
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Meta-Analysis of Randomized Clinical Trials Comparing Intraumbilical Versus Periumbilical Incision in Laparoscopic

Justyna Mohr1, Pascal Probst2, Eva Kalkum3

  • 1Department of Surgery, Cantonal Hospital Thurgau, Münsterlingen, Switzerland.

World Journal of Surgery
|July 14, 2025
PubMed
Summary

This review found no significant difference in outcomes between intraumbilical and periumbilical incisions for laparoscopic appendectomy port placement. Surgeons can choose their preferred method for appendicitis treatment.

Keywords:
intraumbilical incisionlaparoscopic appendectomymeta‐analysisperiumbilical incisionsystematic review

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Area of Science:

  • Surgical Innovation
  • Minimally Invasive Surgery
  • Gastrointestinal Surgery

Background:

  • Laparoscopic appendectomy is standard for acute appendicitis, but surgical site infections occur in up to 8% of patients.
  • Umbilical port placement is crucial for minimally invasive procedures.
  • Variations in umbilical incision techniques may impact patient outcomes.

Purpose of the Study:

  • To compare short- and long-term outcomes of intraumbilical versus periumbilical incisions for the umbilical port in laparoscopic appendectomy.
  • To evaluate the impact of different umbilical port incision techniques on surgical site infections and other complications.
  • To synthesize evidence from randomized clinical trials on umbilical port placement in appendectomy.

Main Methods:

  • Systematic literature search of CENTRAL, PubMed, Embase, and Web of Science.
  • Meta-analysis of four outcome variables using a random-effects model.
  • Assessment of risk of bias (Cochrane 2.0) and certainty of evidence (GRADE).

Main Results:

  • Six randomized clinical trials (RCTs) with 1576 patients were included.
  • Intraumbilical incisions showed little to no effect on operation time and length of hospital stay (very low certainty evidence).
  • No significant difference was found in internal organ injury or umbilical surgical site infections (low certainty evidence).

Conclusions:

  • Current evidence suggests minimal difference in short-term clinical outcomes between intraumbilical and periumbilical port placement in laparoscopic appendectomy.
  • Surgeons are advised to use their preferred approach for umbilical port placement.
  • High-quality RCTs in Western populations and data on long-term outcomes are needed to strengthen the evidence base.