Cosmetic outcomes of infraumbilical, supraumbilical, and transumbilical entry routes in laparoscopic surgery

Özet

Objective: The aim of the present study was to determine which of the umbilical entry routes for intraperitonealaccess has a better cosmetic result.Material and Methods: This was a prospective study (Canadian Task Force classification II-1). In total, 105 patientswho underwent laparoscopic surgery were included. A vertical or transverse umbilical incision is appropriatelymade for the trocar to be inserted, and an infraumbilical, supraumbilical, or transumbilical route was preferred forinitial 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 scarproperties at postoperative week 12 were prospectively collected and analyzed. The Vancouver scar scale was usedto 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 higherin patients who had transverse incisions. There was no statistically significant effect of using a Veress needle withthe cosmetic results. There was no statistically significant correlation between age, gravida, body mass indices, skinthickness, time of entry, duration of the operation, and cosmetic results in terms of vascularity, height, and totalscore.Conclusion: During laparoscopic surgery, each patient should be assessed individually for the satisfaction of thepatient and, thereby, of the surgeon in terms of cosmetic outcomes. Vertical incision offers superior cosmetic effectsthan transverse incision. Further research is required to define long-term scar-related outcomes of the laparoscopicintraperitoneal access techniques.