Single-stage laparoscopic surgery for bilateral organ tumors using a transumbilical approach with a zigzag incision: a report of two cases

Abstract

BackgroundReduced port laparoscopic surgery (RPLS) is comparable to conventional multiport laparoscopic surgery and has the potential to provide improved cosmesis and decreased pain; as such, it satisfies a growing demand for less invasive surgical procedures. Moreover, a zigzag incision of the umbilicus results in a less visible scar in plastic surgery. Here we report a series of two cases with bilateral organ tumors treated by single-stage RPLS using a combination of a transumbilical approach and a zigzag incision.Case presentationCase 1: A 63-year-old man was diagnosed with right renal cell carcinoma (RCC) (clear cell carcinoma, pT1a, venous invasion (−)) and a splenic tumor (cavernous hemangioma). Case 2: An 84-year-old woman was diagnosed with concurrent left RCC (clear cell carcinoma, pT1b, 65 × 65 mm, venous invasion (+)) and ascending colon cancer (adenocarcinoma pT3 with no nodal involvement (0/48)). The perioperative course was uneventful in both cases. However, an additional incision was required in Case 2 for specimen excision. Therefore, the scars were more obvious in Case 2 than in Case 1.ConclusionsAlthough more cases are required to evaluate the superiority of this technique, this novel procedure could be considered for patients with bilateral lesions.

Reduced port laparoscopic surgery using umbilical zigzag incision for Meckel’s diverticulitis

“…Since then, various cases have been reported. Kato et al reported two cases in which single-stage laparoscopic surgery was performed for bilateral organ tumors using a transumbilical approach with a zigzag incision [ 6 ]. Umeda et al reported 5 cases in which reduced port endo laparoscopic surgery was performed using an umbilical zigzag incision for cholecystectomy, partial gastrectomy, cecal wedge resection, left colectomy, sigmoidectomy, low anterior resection, right colectomy [ 7 ].…”

“…On the other hand, an umbilical zigzag incision in laparoscopic surgery may potentially include some problems. Kato et al suggested that an additional incision was required for cases with larger specimens [ 6 ]. However, after a few months, incised wound was less noticeable in comparison to cases without an additional incision.…”

Effect of the combination of composite skin grafting and recombinant human basic fibroblast growth factor on plastic surgery for extensive sc ars after burns

“…The excluded patients were those with mental problems or patients unable to communicate with others, as well as patients with malignant tumors, coagulation abnormalities, and liver and kidney dysfunctions [11]. Moreover, malnourished patients, subjects with a history of drug dependence and patients who were using hormonal and immunosuppressive drugs, were excluded [12].…”