Cosmetic outcomes of infraumbilical, supraumbilical, and transumbilical entry routes in laparoscopic surgery
1Department of Obstetrics And Gynecology, Medeniyet University School Of Medicine, İstanbul, Turkey
2Department of Obstetrics And Gynecology, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey
3Department of Obstetrics And Gynecology, Zeynep Kamil Training and Research Hospital, İstanbul, Turkey
4Department of Obstetrics And Gynecology, Bayburt Government Hospital, İstanbul, Turkey
Objective: The aim of the present study was to determine which of the umbilical entry routes for intraperitoneal access has a better cosmetic result.
Material and Methods: This was a prospective study (Canadian Task Force classification II-1). In total, 105 patients who underwent laparoscopic surgery were included. A vertical or transverse umbilical incision is appropriately made for the trocar to be inserted, and an infraumbilical, supraumbilical, or transumbilical route was preferred for initial intraperitoneal access. Demographic data of patients, body mass indices, entry point of the trocars (infraumbilical–transumbilical–supraumbilical), type of incision (vertical–transverse), duration of the operation, and scar properties at postoperative week 12 were prospectively collected and analyzed. The Vancouver scar scale was used to evaluate the cosmetic results.
Results: Cosmetic results did not differ statistically between the transumbilical–infraumbilical–supraumbilical groups. The variables, such as vascularity, height, and total score, of the Vancouver scar scale were significantly higher in patients who had transverse incisions. There was no statistically significant effect of using a Veress needle with the cosmetic results. There was no statistically significant correlation between age, gravida, body mass indices, skin thickness, time of entry, duration of the operation, and cosmetic results in terms of vascularity, height, and total score.
Conclusion: During laparoscopic surgery, each patient should be assessed individually for the satisfaction of the patient and, thereby, of the surgeon in terms of cosmetic outcomes. Vertical incision offers superior cosmetic effects than transverse incision. Further research is required to define long-term scar-related outcomes of the laparoscopic intraperitoneal access techniques.
Keywords: Cosmetic outcome, laparoscopic surgery, umbilical incision, scarless surgery
Cite this paper as: Şentürk MB, Doğan O, Polat M, Kılıçcı Ç, Pulatoğlu Ç, Tanar AT. Cosmetic outcomes of infraumbilical, supraumbilical, and transumbilical entry routes ın laparoscopic surgery. Turk J Surg 2018; 34(4): 290-294.
The local ethics committee approved the study (NCT02672956/129).
Written informed consent was obtained from all patients who participated in this study.
Concept - M.B.Ş., O.D., Ç.K.; Design - M.B.Ş., O.D., Ç.P.; Supervision - M.P., AT.T., O.D.; Resource - M.P., Ç.P., A.T.T.; Materials - M.B.Ş., O.D., M.P.; Data Collection and/or Processing - O.D., Ç.P., M.P.; Analysis and/or Interpretation - A.T.T., O.D., M.B.Ş.; Literature Search - O.D., Ç.P. ; Writing Manuscript - O.D., Ç.P., M.B.Ş.; Critical Reviews - Ç.K., O.D., M.B.Ş.
The authors declare no conflict of interest.
The authors declared that this study has received no financial support.