Our Summary

This research paper discusses a study that was conducted to find out which type of incision, around or through the belly button, is better for starting laparoscopic abdominal surgery, which is a minimally invasive procedure that uses a small device called a trocar. Researchers analyzed data from several other studies, involving 783 patients in total.

The results showed that making an incision through the belly button can significantly reduce the time it takes to perform the surgery, compared to making an incision around the belly button. However, they found that the two methods did not significantly differ in terms of the average length of hospital stay, the level of pain patients experienced on the day of the surgery and the day after, the incidence of infection at the surgical site, how satisfied patients were with the cosmetic result, or the rate of complications.

Based on these findings, the researchers suggest that surgeons should consider using an incision through the belly button when starting laparoscopic abdominal surgery, as it can save time.

FAQs

  1. What is the difference between a transumbilical and a periumbilical incision in laparoscopic surgery?
  2. Based on the studies, which type of incision is more beneficial in terms of operation time in laparoscopic surgery?
  3. Does the type of incision affect the length of hospital stay, mean pain scores, and incidence of surgical site infection in laparoscopic surgery?

Doctor’s Tip

A helpful tip a doctor might tell a patient about laparoscopic surgery is to follow the post-operative care instructions carefully, including taking prescribed medications, avoiding strenuous activities, and keeping the incision site clean and dry to prevent infection. Additionally, staying in communication with your healthcare provider and attending follow-up appointments is important for monitoring your recovery progress.

Suitable For

Patients who are recommended for laparoscopic surgery typically include those with conditions such as:

  1. Gallbladder disease (such as gallstones or inflammation)
  2. Appendicitis
  3. Hernias
  4. Endometriosis
  5. Ovarian cysts
  6. Gastroesophageal reflux disease (GERD)
  7. Colorectal conditions (such as diverticulitis or colorectal cancer)
  8. Pancreatitis

It is important for patients to consult with their healthcare provider to determine if laparoscopic surgery is the best option for their specific condition.

Timeline

Before laparoscopic surgery:

  1. Patient consults with a surgeon and discusses the need for surgery.
  2. Pre-operative tests and evaluations are conducted to ensure the patient is a suitable candidate for laparoscopic surgery.
  3. Patient receives instructions on pre-operative preparations, such as fasting before surgery.
  4. Patient undergoes anesthesia before the surgery begins.

During laparoscopic surgery:

  1. Surgeon makes either a transumbilical or periumbilical incision for initial peritoneal access.
  2. Laparoscopic instruments and a camera are inserted through the incision to perform the surgery.
  3. Surgery is completed using minimally invasive techniques.

After laparoscopic surgery:

  1. Patient is monitored in the recovery room before being transferred to a hospital room or discharged home.
  2. Patient may experience some pain and discomfort at the incision site.
  3. Patient is given instructions for post-operative care, such as pain management and wound care.
  4. Follow-up appointments are scheduled to monitor the patient’s recovery and address any concerns.

What to Ask Your Doctor

  1. What are the potential benefits of using a transumbilical incision for laparoscopic surgery compared to a periumbilical incision?
  2. Are there any specific risks or complications associated with using a transumbilical incision for laparoscopic surgery?
  3. How does the use of a transumbilical incision impact the overall recovery process and length of hospital stay?
  4. Will the cosmetic outcome of the surgery be affected by using a transumbilical incision instead of a periumbilical incision?
  5. Are there any specific factors or criteria that make a patient a better candidate for a transumbilical incision in laparoscopic surgery?
  6. How common is the use of a transumbilical incision for laparoscopic surgery in your practice, and what is your experience with this technique?
  7. What should I expect in terms of postoperative pain management and discomfort with a transumbilical incision for laparoscopic surgery?
  8. Will there be any restrictions or limitations on my activities or diet following laparoscopic surgery with a transumbilical incision?
  9. How will the use of a transumbilical incision impact the overall success and effectiveness of the laparoscopic procedure being performed?
  10. Are there any alternative incision techniques that may be considered for my specific case, and how do they compare to a transumbilical incision in terms of outcomes and recovery?

Reference

Authors: Shih SL, Chen BH, Tam KW. Journal: Am J Surg. 2020 Dec;220(6):1592-1598. doi: 10.1016/j.amjsurg.2020.04.031. Epub 2020 Apr 27. PMID: 32370874