A comparison of the periumbilical incision and the intraumbilical incision in laparoscopic appendectomy

Abstract

PurposeThe intraumbilical incision is being used more frequently, with increasing cases of single incision laparoscopic surgery. Since the umbilicus is deeper than the surrounding wall, it has abundant bacteria. No study has compared the adverse outcomes of periumbilical and intraumbilical incisions. We analyzed the wound complication rates of perforated appendicitis patients according to the types of umbilical incision.MethodsA retrospective review was done of 280 patients with perforated appendicitis. One hundred fifty nine patients were treated with the intraumbilical incision, and 121 patients were treated with the periumbilical incision. We compared the perioperative outcomes according to each laparoscopic incision.ResultsThere was no difference in operation time, postoperative hospital stay and analgesic requirement between the two groups. One case in the intraumbilical group (0.6%) and three cases in the periumbilical group (2.5%) developed wound infections. The umbilical complication rate showed no difference.ConclusionThe wound complication rate of intraumbilical and periumbilical incisions are not different. Although this retrospective study has inherent limitations, the intraumbilical incision seems to be a safe and feasible alternative for the periumbilical incision that can be easier to perform, with better cosmetic results.

A comparison of transumbilical single-port laparoscopic appendectomy and conventional three-port laparoscopic appendectomy: from the diagnosis to the hospital cost

“…This is quite different to the previous studies that showed TULA group's operative time at about 5-10 minutes longer than CTLA group's [26,27]. Even a study conducted by Kim et al [28] presented about 15 minutes more of operative time in TULA group, which was statistically significant.…”

Aesthetic Outcomes of Intra-Umbilical Incision vs Infra-Umbilical Incision in Postpartum Tubal Sterilization: A Randomized Controlled Trial

“…3, 5-8. Several intra-umbilical surgeries, involving intra-umbilicus skin opening, exist including umbilical hernia repairs and various laparoscopic operations in surgical or gynecological conditions particularly single port laparoscopic sterilization. [2][3][4][5][6][7][8][9][10]…”

“…Intra-umbilicus incisions for single port laparoscopic surgeries have become popular, partly due to greater patient satisfaction regarding aesthetics of the wounds and similar complication rates compared to infra-umbilicus incisions. [3][4][5][6][7][8] However, earlier studies mostly focused on patient aesthetic concerns, as timing of the operation could not be controlled for various operations. Our study supported the findings that patients were more satisfied with their surgical wounds after intra-umbilicus incision.…”

“…When compared to infra-umbilical skin incisions, an incision wound was invisible after the operation and an increase in wound infection has not been reported. 3,4 Anatomically, the overlying skin inside the umbilicus is thinner than that of normal skin, infra-umbilicus. In pregnant women, the base of an umbilicus usually raises as the uterus enlarges, allowing easier access for an intraumbilical skin incision.…”

Feasibility of the Short Hospital Stays after Laparoscopic Appendectomy for Uncomplicated Appendicitis

“…Recently, many efforts have been made to reduce hospital costs, and the topic of shortening hospital stay after appendectomy has attracted some interest, especially in the context of one-day surgery, 1 , 2 , 3 , 4 because hospital stays after appendectomy usually exceed 3 days. 5 , 6 , 7 , 8 , 9 The reports issued on this topic have cited hospital stays of from 2.2 to 6 days after uncomplicated appendectomy. 6 , 7 , 8 , 9 , 10 , 11 …”