Transumbilical laparotomy: a cosmetic and minimally invasive operative route in pediatric patients / 中国现代普通外科进展

ABSTRACT

Objective:The feasibility of a minimally invasive cosmetic transbilical laparotomy was studied in fifty-seven pediatric patients.The advantages of this technique will be discussed.Methods:The circumferential incision was made following the ring fold of the right umblilicus,which was less than 2700.The peritoneum was opened in the midline via rectus abdominis.Intra-peritoneal lesions were detected and explored.The surgical procedures were able to be carried out either inside or outside of the peritoneum.After closure of peritoneum,the umbilical incision was closed subcutaneously with an absorbable suture.Results:From January 2001 to January 2005,58 procedures via transumbilical route have been done in 57 pediatric patients.None of those cases required conversion to a traditional abdominal incision.The duration of surgery was from 20 to 170 minutes.All patients were discharged five days postoperatively and follow-up was conducted from 3 months to 4 years.No complications were observed in all but one patient.This patient had a leaking anastamosis.No visible scars were present and the cosmetic results were excellent.All patients had shorter hospital stay and lower operating cost.Conclusion:Transumbilical approach is a feasible,safe,economical,minimally invasive procedure with excellent cosmetic results which appears to be superior to traditional procedures.It suggests that the transumbilical route should be widely used clinically and might be applicable for elder children and possibly would be of benefit in the treatment of other conditions.