Transumbilical single-access laparoscopic perforated gastric ulcer repair

Abstract

Introduction: In patients presenting with peritonitis, laparoscopy offers the possibility of diagnosis as well as treatment, with less abdominal trauma, reduced postoperative pain, and shorter hospital stay.

Case report: A 30-year-old woman, presenting with diffuse abdominal pain and free pneumoperitoneum, was submitted to transumbilical single-access laparoscopy. The procedure was performed using a standard 11-mm reusable trocar in the umbilicus and curved reusable instruments inserted transumbilically without trocars. The cavity exploration showed a perforated gastric ulcer at the anterior surface of the prepyloric area. A gastric suture repair, omentoplasty, and lavage of the cavity were performed.

Results: The umbilical incision was 15 mm and laparoscopy lasted 86 minutes. Use of painkillers was minimal, and the patient was discharged on the fifth postoperative day. After 6 months, the umbilical scar was no visible.

Conclusions: Transumbilical single-access laparoscopy can be proposed in selected patients presenting perforated gastric ulcer, with the main advantage of improved cosmetic results.