Intraumbilical versus periumbilical incision in laparoscopic cholecystectomy: A randomized controlled trial

• The operative results of the intraumbilical (IU) incision and the periumbilical (PU) incision placed below the umbilicus were analyzed.
• 130 patients who received laparoscopic cholecystectomy were randomly allocated in to either the IU or PU groups.
• In the IU group, the operation time was shorter and the cosmetic survey score was higher than the PU group.
• There was no difference in complication rates between the two groups.
• The IU incision is a safe, feasible method that can reduce operation time.

IntroductionAn important issue in laparoscopic surgery is initial peritoneal access. An intraumbilical (IU) incision may be easier and faster to place, but due to concerns about wound complications, the periumbilical (PU) incision is still often used. A prospective randomized controlled study was performed to investigate the outcomes of the IU incision and PU incision in laparoscopic cholecystectomy.MethodsStudy subjects were patients who received laparoscopic cholecystectomy for acute or chronic cholecystitis, gallbladder polyp or adenomyomatosis, or porcelain gallbladder from June 2014 to January 2015. Enrolled subjects were randomly allocated to the IU incision group or the PU incision group. Demographic data, perioperative outcomes, and the results of a cosmetic satisfaction questionnaire were analyzed.ResultsA total of 130 subjects were analyzed (64 in the IU group, 66 in the PU group). There were no differences in patient demographics. The operation time was significantly shorter in the IU group (34.2 ± 14.6 vs 41.7 ± 21.3, P = 0.020). The cosmetic survey score was significantly higher in the IU group (36.8 ± 5.2 vs 33.2 ± 5.2, P < 0.001). There was no difference in the complication rates of the two groups.ConclusionsThe IU incision is a safe, feasible method of initial intraperitoneal access that can reduce the operation time and offer superior cosmetic effects to the patient.