A new paradigm of scarless abdominal surgery in children: Transumbilical minimal incision surgery

Tsuji, Yosuke; Murakami, Kosaku; Ono, Shigeru; Yanagisawa, Satohiko; Baba, Katsuhisa; Usui, Yoshiko

doi:10.1016/j.jpedsurg.2014.06.009

Cited by 11 publications

(8 citation statements)

References 15 publications

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“…described the so-called, U-u umbilicoplasty [9]. A circumumbilical incision with an omega-shaped extension, as seen in the present study, has also been reported in previous studies [2,3,10].…”

Section: Discussionsupporting

confidence: 85%

“…Previous studies have described laparotomies via circumumbilical incision [2,3]. According to the underlying disease, a semicircular, supra-or infra-umbilical incision was made along the umbilical contour.…”

Section: Surgical Technique: Circumumbilical Incisionmentioning

confidence: 99%

“…The transumbilical approach in laparotomy was rst described in 1986. While it was originally used in pyloromyotomies in children with hypertrophic pyloric stenosis [1], it is now widely applied to children with various diseases, having come to represent a new paradigm for minimally invasive surgery [2]. The versatility of this technique lies in the fact that the umbilicus has a natural skin crease towards the center of the abdomen which hides the surgical scar, resulting in favorable postoperative cosmesis [3].…”

Section: Introductionmentioning

confidence: 99%

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Vertical umbilical incision achieves better cosmesis than circumumbilical incision in transumbilical laparotomy in neonates and young infants

Tomita

Shimojima

Shimotakahara

et al. 2022

Preprint

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Purpose: The transumbilical approach is widely used for minimally invasive surgery in children. We compared herein the postoperative cosmesis between two types of transumbilical approach, one involving a vertical incision and the other involving a circumumbilical incision.Methods: Patients with a transumbilical laparotomy before age 1 year were prospectively enrolled between January 2018 and December 2020. A vertical or circumumbilical incision was chosen at the surgeon’s discretion. A questionnaire about the appearance of the umbilicus was completed by the patients’ guardians at postoperative month 6 to assess satisfaction and determine the visual analog scale score. Patients receiving a relaparotomy via another site were excluded.Results: Forty patients were enrolled; 24 patients received a vertical incision while 16 received a circumumbilical incision. The incision length was significantly shorter in the vertical incision group (median: 2.0; range: 1.5–3.0 cm vs. median: 2.75; range: 1.5–3.6 cm) (P = 0.001). The patients’ guardians reported significantly higher satisfaction (P = 0.002) and higher scores on the visual analog scale (P = 0.046) in the vertical incision group (n = 22) than in the circumumbilical incision group (n = 15).Conclusion: A vertical umbilical incision can provide better, postoperative cosmesis than a circumumbilical incision.

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Section: Discussionsupporting

confidence: 85%

Section: Surgical Technique: Circumumbilical Incisionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Vertical umbilical incision achieves better cosmesis than circumumbilical incision in transumbilical laparotomy in neonates and young infants

Tomita

Shimojima

Shimotakahara

et al. 2022

Preprint

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“…Como se ha venido apreciando en la actualidad, cada vez se realizan con mayor frecuencia procedimientos mínimamente invasivos en la población de pacientes pediátricos (14); (15), incluyendo a los recién nacidos y lactantes, quienes al ser asistidos en la mayoría de las operaciones abdominales en cirugía de forma mínimamente invasiva por laparoscópica se reduce la duración de la estancia hospitalaria, se minimizar el dolor posoperatorio y generar resultados más estéticos (16).…”

Section: Discussionunclassified

Ventajas de la desinvaginación neumática asistida por laparoscopia versus técnica convencional.

Cedeño-Moreira

Acosta-Farina

León-Ochoa

et al. 2022

Más Vita. Rev. Cienc. Salud

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Introducción. La invaginación intestinal es una de las casusas más frecuentes en lactantes de abdomen agudo obstructivo, su diagnóstico se encuentra bien definidos ante el cuadro clínico característico, y su manejo dependerá de varios factores. Objetivo. Comparar las técnicas quirúrgicas, desinvaginación neumática asistida por laparoscopia con la técnica convencional (Laparotomía) en pacientes pediátricos intervenidos quirúrgicamente durante el periodo de enero del 2019 a diciembre del 2021 en el hospital de niños Roberto Gilbert Elizalde. Materiales y métodos. Se ha empleado como metodología un estudio cuantitativo, retrospectivo de tipo relacional, basado en el análisis de las historias clínicas de los pacientes tratado quirúrgicamente durante el periodo de enero del 2019 a diciembre del 2021; los datos recolectados fueron procesados ??en el programa estadístico SPSS Versión 25, donde se han obtenido frecuencias porcentajes y para observar la asociación entre variables se empleó la prueba de ?2, Resultados. La edad promedio fue de 1.3 años, del total de 50 (100%) pacientes 41(82%) de sexo masculino y 9 (18%) de género femenino. Fueron intervenidos mediante laparoscopia neumática 31 pacientes (62%) mientras que a 18 (36%) se les realizó laparotomía exploradora + taxia desinvaginante. En un porcentaje mayoritario a 47 pacientes (94%) se le realizó ecografía mientras que solo a 3 pacientes (6%) se le realizó tomografía. En relación al tiempo quirúrgico en 26 (52%) se utilizó hasta 60 minutos, en 22 pacientes (44%) entre 61 y 119 minutos y en menor grado, con 2 (4%) se utilizó de 120 o más en adelante. Conclusión. El procedimiento a través de la desinvaginación neumática asistida por laparoscópica, alcanzo ventajas sobre el procedimiento quirúrgico convencional por laparotomía, ya que el primero permitió brindar un excelente tratamiento quirúrgico mediante mínima invasión, apreciándose diferencias significativas respecto a valores de tiempos quirúrgicos, un pronto transito gastrointestinal, tiempo de hospitalización, menor dolor posoperatorio así como incisiones menos invasivas con rápida y mejor cicatrización. ABSTRACT Introduction. It is relatively common to observe in infants the condition of intestinal invagination, its diagnosis and treatment are well defined given the clinical picture that is presented. Goal. To compare the surgical techniques, laparoscopy-assisted pneumatic disinvagination with the conventional technique (Laparotomy) in pediatric patients who underwent surgery during the period from January 2019 to December 2021 at the hospital Roberto Gilbert Elizalde. Methodology. A quantitative, retrospective relational study was used as a methodology, based on the analysis of the medical records of patients treated surgically during the period from January 2019 to December 2021; The data collected was processed in the statistical program SPSS Version 25, where percentage frequencies have been obtained and to observe the association between variables, the ?2 test, Results, was used. The average age was 1.3 years, of the total of 50 (100%) patients, 41 (82%) male and 9 (18%) female. 31 patients (62%) underwent pneumatic laparoscopy, while 18 (36%) underwent exploratory laparotomy + disinvaginating taxia. In a majority percentage, 47 patients (94%) underwent ultrasound while only 3 patients (6%) underwent tomography. In relation to surgical time, in 26 (52%) it was used up to 60 minutes, in 22 patients (44%) between 61 and 119 minutes and to a lesser degree, with 2 (4%) it was used from 120 or more. Conclusion. The procedure through laparoscopic-assisted pneumatic disinvagination, achieved advantages over the surgical procedure by laparotomy, since the former allowed to provide an excellent minimally invasive surgical treatment, appreciating significant differences regarding the different values ??of time, an early gastrointestinal transit and by making less invasive incisions, the recovery of patients has been faster

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“…8 This is consistent with previous studies in which transumbilical incisions were not associated with increased surgical site infections or incidence of hernia. [26][27][28] Considering the high prevalence of appendectomy, the costeffectiveness of surgery should be considered. Compared with CLA and TUSPLA, the cost savings of SITPLA, with only the need for a trocar/miniport introducer and endobag, were 10% and 30% in our institution, respectively.…”

Section: Discussionmentioning

confidence: 99%

Single-Incision, Two-Port Laparoscopic Appendectomy as an Alternative to Transumbilical Single-Port Laparoscopic Appendectomy

Chung

Jung

Lee

et al. 2019

J Minim Invasive Surg

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We designed a modified technique to perform an advanced procedure using conventional instruments and did not employ specialized single-incision laparoscopic surgery (SILS) port equipment. We compared postoperative results for transumbilical, single-port laparoscopic appendectomy (TUSPLA) and single-incision, 2-port laparoscopic appendectomy (SITPLA). Methods: This retrospective study enrolled 77 patients who underwent TUSPLA or SITPLA to provide more minimally invasive surgery between May 2017 and April 2018. TUSPLA was performed in 39 patients and 38 underwent SITPLA. In the SITPLA group, two 5-mm trocars were inserted through the umbilicus and an extra puncture site was used for a left-handed instrument. Demographic characteristics, operative data, and postoperative outcomes were collected and compared between the groups. Results: The mean total operative time in the SITPLA group was shorter than in the TUSPLA group (p=0.003). The mean laparoscopic instrumental time was also shorter (p<0.001) in the SITPLA. The number of postoperative analgesics in the SITPLA group was less than in the TUSPLA group (p=0.002). The length of hospital day after surgery was shorter in the SITPLA group than in the TUSPLA group (p=0.008). There were no other significant differences between the groups. Conclusion: SITPLA had a shorter operative time, required less pain management, and had a similar cosmetic outcome when compared with TUSPLA.

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A new paradigm of scarless abdominal surgery in children: Transumbilical minimal incision surgery

Cited by 11 publications

References 15 publications

Vertical umbilical incision achieves better cosmesis than circumumbilical incision in transumbilical laparotomy in neonates and young infants

Vertical umbilical incision achieves better cosmesis than circumumbilical incision in transumbilical laparotomy in neonates and young infants

Ventajas de la desinvaginación neumática asistida por laparoscopia versus técnica convencional.

Single-Incision, Two-Port Laparoscopic Appendectomy as an Alternative to Transumbilical Single-Port Laparoscopic Appendectomy

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