A Semicircular Incision in the Superior Umbilical Fold for SILS Preserves the Umbilical Profile

Abstract

Background. Single Incision Laparoscopic Surgery (SILS) has been highlighted in the recent literature as a means of performing a range of common, minimal access, paediatric surgical procedures. The primary attraction is the absence of visible scarring. Aim. This study aims to describe a cosmetically advantageous means of SILS port placement in children, which preserves the umbilical profile. Methods. We describe a paediatric case series utilising a semicircular incision in the superior umbilical fold for SILS procedures. The linea alba is exposed over 2 cm just superior to the umbilical ring and stay sutures are applied. A vertical incision is made over this distance without entering the umbilical ring. Data were recorded prospectively in a Microsoft Excel database. Results. Twenty-one cases were performed in a 1-year period. Ten appendicectomies, 5 ovarian/paraovarian cystectomies, 2 Palomo procedures, 3 nephrectomy/heminephrectomies, and 1 Meckel's diverticulectomy were performed. There was 1 wound infection. No incisional hernias occurred. Discussion. We believe that our technique, which maintains the integrity of the umbilical ring and allows preservation of the umbilical profile, offers a distinct cosmetic advantage over other incisions for SILS which distort it. Conclusion. We have demonstrated the aesthetic benefits of utilising a superior umbilical-fold incision for SILS in children.

The Umbilical Benz Incision for Reduced Port Surgery in Pediatric Patients

“…Special umbilical incisions such as the circumumbilical incision and omega-shaped incision have been proposed as simple techniques to provide acceptable cosmetic results in patients undergoing laparoscopic procedures that require specimen extraction. 5 – 7 However, over three quarters of the circumference of the umbilicus is prone to umbilical ischemia and deformity of the natural umbilical profile. Wounds outside the umbilical ring, such as those occurring with the circumumbilical or omega-shaped incision, typically result in scar formation, although scarring inside the umbilicus is generally invisible.…”