A new paradigm of scarless abdominal surgery in children: transumbilical minimal incision surgery

J Pediatr Surg. 2014 Nov;49(11):1605-9. doi: 10.1016/j.jpedsurg.2014.06.009. Epub 2014 Aug 27.

Abstract

Purpose: This study aimed to evaluate the use of a transumbilical incision for infants and children, as well as neonates, with various intraabdominal conditions.

Methods: A retrospective study of transumbilical incision surgery was performed between June 2007 and June 2013. Patients were divided into two groups: group 1 of neonates and group 2 of infants and children. All operations were performed via an upper circumumbilical incision.

Results: Thirty-six patients (22 males, 14 females) were treated via a transumbilical incision, with 20 patients in group 1 and 16 patients in group 2. A transverse incision extension was needed for 1 case in group 1 (intestinal atresia complicated by meconium peritonitis) and 4 cases in group 2 (two with ileus owing to adhesive bands, 1 with malrotation, 1 with ectopic pancreatic tissue in the duodenum). In cases with a dilated intestinal wall or intraabdominal adhesions, an optional extension of the transverse incision might be required. Only 1 case with ileus in group 2 developed a wound infection that was treated by drainage. The postoperative cosmetic results were acceptable in all cases.

Conclusion: The transumbilical incision yielded a sufficiently large surgical field, and the surgical condition was easily and directly viewed. In all 36 cases, an adequate operation was safely performed. This approach is a safe and effective method for various intraabdominal disorders in not only neonates but also infants and children, and leads to an imperceptible incision.

Keywords: Children; Minimal incision surgery; Transumbilical incision.

MeSH terms

  • Child
  • Child, Preschool
  • Digestive System Surgical Procedures / methods*
  • Female
  • Gastrointestinal Diseases / surgery*
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Minimally Invasive Surgical Procedures / methods*
  • Retrospective Studies
  • Treatment Outcome
  • Umbilicus