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Updated: Jul 23, 2026

Laparoscopic Left Lateral Sectionectomy: Guided by the Ligamentum Teres Hepatis and the Umbilical Fissure Vein

Laparoscopic Left Lateral Sectionectomy: Guided by the Ligamentum Teres Hepatis and the Umbilical Fissure Vein

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Laparoscopic cholecystectomy and the umbilicus

A H Nassar¹, K A Ashkar, A A Rashed

¹Department of Surgery, King Khalid National Guard Hospital, Jeddah, Kingdom of Saudi Arabia.

The British Journal of Surgery

|May 1, 1997

Summary

Umbilical defects are common in laparoscopic surgery patients, often asymptomatic. Proper technique and repair minimize incisional hernia risks, with specific considerations for larger defects and male patients with umbilical hernias.

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Area of Science:

Laparoscopic surgery
Surgical complications
Hernia research

Background:

Pre-existing umbilical defects pose challenges during laparoscopic procedures.
Postoperative fascial defects can also occur, necessitating understanding of herniation mechanisms.
Identifying causes of port site herniation aids in preventing serious complications.

Purpose of the Study:

To investigate the incidence, management, and complications of umbilical defects in laparoscopic cholecystectomy.
To analyze risk factors for incisional hernia development after laparoscopic surgery.

Main Methods:

Study involved 870 patients undergoing laparoscopic cholecystectomy.
Data collected on incidence, management, and complications of umbilical and incisional hernias.

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Analysis of risk factors for incisional hernia, including wound extension, sex, infection, and comorbidities.

Main Results:

Umbilical or paraumbilical defects found in 12% of patients, mostly asymptomatic.
90% of umbilical defects repaired easily with absorbable sutures; recurrence rate was 3.8%.
Incisional hernia occurred in 1.8% of patients, with wound extension, male sex, and infection as key risk factors.

Conclusions:

High incidence of umbilical defects requires accurate diagnosis and skilled surgical technique.
Minimizing wound extension and using appropriate sutures (non-absorbable for >2cm defects/men with umbilical hernia) can reduce incisional hernia rates.