New: Single-incision transumbilical laparoscopic surgery

Summary  BACKGROUND: On the way to "no-scar" techniques novel single-incision laparoscopic methods are developed, which result in a non-visible postoperative scar. METHODS: A total of 136 patients (age 10–86a; 68f/68m) underwent single-incision laparoscopic surgery at our Department for diseases of the appendix, gallbladder, colon, esophagus, liver, adrenal gland, inguinal hernia, or symptomatic adhesions. The entire operations were carried out transumbilically following the standardized procedural principles. RESULTS: Operative time ranged from 17 to 218 min. In 16 patients (11.8%) additional trocars were inserted for procedural safety. No intraoperative adverse event or significant perioperative complication was noticed. Operative estimated blood loss yielded minimal, blood suction was needed only for liver resection and adrenalectomy. Specimen retrieval was carried out either by means of an endo-bag or directly utilizing a transumbilical protection sheet. Patients resumed oral intake at the day of surgery after cholecystectomy, hernia repair or appendectomy, or within 24 h after major surgery according to the principles of fast-track abdominal surgery. Patients' discharge was on postoperative days 1–12 (Mean 3.8 d). At follow-up after 1–4 weeks patients presented with an optimal cosmetic result without apparent scarring. CONCLUSIONS: Single-incision transumbilical laparoscopy allows further reduction of the surgical trauma and to obviate any visible scar in various procedures.