PMID: 9171748May 1, 1997Paper

Laparoscopic cholecystectomy and the umbilicus

The British Journal of Surgery
A H NassarM G Abdulmoneum

Abstract

Pre-existing umbilical defects may present technical problems in patients having laparoscopic surgery. Fascial defects may also occur after operation. Understanding the causes and mechanisms of herniation at laparoscopic port sites may help avoid potentially serious postoperative complications. The incidence, management and potential complications of pre-existing and postoperative umbilical defects were studied in 870 patients undergoing laparoscopic cholecystectomy. The incidence of umbilical or paraumbilical defects was 12 per cent. The hernias were symptomatic in only 16.3 per cent; the majority of patients were unaware of the defect. The umbilical port was established through, or directly adjacent to, the defect, allowing simple anatomical repair in 90 per cent, using absorbable sutures. The recurrence rate was 3.8 per cent; recurrence was usually caused by wound extension or infection. Incisional hernia occurred in 16 patients after cholecystectomy (1.8 per cent). Only one hernia developed at a port site other than the umbilicus. Risk factors associated with incisional hernia were wound extension in 12 patients, male sex in six, wound infection in five, diabetes in four, pre-existing umbilical hernia in four and acute chol...Continue Reading

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Citations

Jul 10, 2001·Surgical Endoscopy·A J Voitk, S G Tsao
Jun 21, 2012·Hernia : the Journal of Hernias and Abdominal Wall Surgery·E ErdasG Farina
Apr 2, 2013·Hernia : the Journal of Hernias and Abdominal Wall Surgery·P C BennettE C Coveney
Apr 2, 2013·The Indian Journal of Surgery·Mriganka Sekhar SharmaNitin Agarwal
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Jan 1, 2009·BMJ Case Reports·Gerrard O'Donoghue, Bruce Mann
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Jun 25, 2014·JSLS : Journal of the Society of Laparoendoscopic Surgeons·Emmanuel Atta AgabaPratibha Vemulapali
Aug 10, 2013·Obesity Surgery·Huseyin YilmazMustafa Sahin
May 31, 2014·Journal of Surgical Case Reports·June LeeChee Yung Ng
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