Umbilical Quilting Suture Technique during Single-Port Laparoscopic Surgery

Abstract

Background and Objectives:Single-port laparoscopic surgery (SPLS) is popular in the gynecological field, because it is less invasive and leaves a smaller scar. However, the postoperative shape of the umbilicus is often distorted due to the intensive procedures performed through the small opening. In this report, we describe a technique for forming a satisfactory umbilicus in SPLS.Methods:From March 2016 through April 2017, 32 patients were treated with SPLS by a single gynecologic surgeon. Group A (14 cases) underwent conventional umbilicus closure, and group B (18 cases) underwent a quilting suture technique. The umbilical shapes of each group were assessed by a plastic surgeon as was the patients' satisfaction. Evaluations were performed immediately after surgery and every month for 6 months thereafter.Results:The postoperative umbilical shape in group A showed features, such as loss of depression, disappearance of the central vertical line, and irregularly bulging tissue, whereas group B had a shape similar to that of the natural umbilicus and maintained its depression and vertical line. The average scores of the plastic surgeons' evaluations immediately after the operation were 10.4 for group A and 15.1 for group B. The final scores obtained 6 months after surgery were 15.2 and 17.8, respectively. The patients' satisfaction scores immediately after the operation were 4.9 for group A and 7.3 for group B. The scores increased gradually, to 8.1 and 9.2, respectively, at 6 months after surgery.Conclusion:Performing quilting sutures during wound closure in SPLS is effective for making an ideal umbilicus and ensuring patients' satisfaction.

Zheng’s anchor suturing technique for safe and cosmetic umbilical incision in transumbilical laparoendoscopic single-site surgeries

“…According to previous studies, the incidence of postoperative umbilical hernia ranges from 0.12 to 13.3% after gynecologic or general surgeries [ 5 ]. To reduce the incidence of umbilical hernia after TU-LESS, surgeons have tried various closure techniques and reported satisfactory results [ 2 , 6 , 7 ], but the number of cases in these reports was small and an optimal method to address the different risk factors was not identified.…”

Laparoscopic-Assisted Relocation of the Umbilicus With Umbilicoplasty in Complex Abdominal Wall Reconstruction

“…An article published in the Journal of the Society of Laparoendoscopic Surgery in 2018 describes umbilical quilting suture techniques during single-port laparoscopic procedures. 3 This article notes that while patients are enthusiastic about having a well-hidden umbilical scar during single-port procedures, often they are dissatisfied about their postoperative umbilical appearance due to distorted shape and increased bulging. Their technique entails placing four cephalad quilting sutures anchoring the superior umbilicus to the underlying fascia to recreate a natural-appearing superior hood.…”