Evaluation of a Transumbilical Incision as an Approach for Organ Removal in Laparoscopy-assisted Colectomy

Abstract

Abstract. Aim: To investigate the risk factors of transumbilical incision for organ removal in laparoscopyassisted colectomy (LAC).In laparoscopic surgery, a transumbilical incision is often used for anastomosis and organ removal. In our Department, we have been performing transumbilical incisions to remove resected organs since shortly after the introduction of laparoscopic surgery. We vertically extend the umbilical wound corresponding to the size of the specimen and anastomose extracorporeally. We have already reported that surgical site infection (SSI) and hernia occurred at a significantly higher rate in colorectal resection than in gastric resection in laparoscopic surgery. Additionally, we showed that female sex and diabetes mellitus (DM) were independent risk factors in relation to hernia (1).The present study aimed to evaluate the complication rates and risk factors associated with transumbilical incisions in laparoscopy-assisted colectomy (LAC). Patients and MethodsThis study included a cohort of 417 consecutive patients who underwent LAC for colorectal cancer at

Use of Transumbilical Incision as an Organ Removal Site in Laparoscopic Pancreatectomy

“…The incidence rate of SSI correlated with transumbilical incision in laparoscopic gastric and colorectal resections were low at 2.64% (4) and those in laparoscopic colectomy were at 4.31% (5). Meanwhile, SSI was not observed in patients who underwent laparoscopic hepatectomy (6) and LP in the current study.…”

“…The results showed that the incidence rate of SSIs and incisional hernias correlated with transumbilical incision were significantly higher in colorectal than in gastric resection in laparoscopic surgery. Moreover, female sex and diabetes mellitus (DM) were considered the independent risk factors for hernia formation, and SSI was not associated with hernia formation (4,5). In addition, a high body mass index (BMI) has been shown to be significantly associated with a greater risk of incisional hernia formation in laparoscopic hepatectomy (6).…”

“…In incisional hernia, the incidence rate of port-site hernia ranged from 0% to 25.9%. Moreover, female sex, DM, SSI, wound extension, and high BMI were considered as risk factors for hernia formation (5,13). There are few studies on transumbilical incisional hernia in LP.…”

Usefulness of a Transumbilical Incision for Organ Removal in Laparoscopic Hepatectomy

“…Concerning incisional hernia, the incidence rates of a portsite hernia have been reported to be 0%-25.9% (3). Furthermore, female sex, DM, SSI, wound size, and high BMI have been identified as risk factors for hernia formation (3,18). The surgical procedure was limited to Lap-H, and the incidence of hernia has been reported to be 1.85-5.9% (17,19,20).…”

“…Adding an incision in the umbilicus has been avoided due to fear of increased rates of surgical site infection (SSI) and postoperative adhesion decades ago; however, it was not associated with complications (2). Furthermore, we have already reported the usefulness of a transumbilical incision as a surgical approach in laparoscopic surgery; infection at the transumbilical wound and incisional hernia occurred at a significantly higher rate following colorectal resection than gastric resection by laparoscopic surgery, and that female sex and diabetes mellitus (DM) were independent risk factors for hernia formation (3,4).…”