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. 2024 Apr 22:11:1390038.
doi: 10.3389/fsurg.2024.1390038. eCollection 2024.

Transumbilical laparoscopy for pneumoperitoneum establishment: a comprehensive multicentre evaluation affirming safety, feasibility, and a range of clinical benefits

Antonia Rizzuto  1 , Cristina Bozzarello  1 , Jacopo Andreuccetti  2 , Angela Amaddeo  1 , Antonio Maria Iannello  1 , Carlo Sagnelli  3 , Roberto Cirocchi  4 , Diego Cuccurullo  3 , Giusto Pignata  2 , Francesco Corcione  5
Affiliations

Transumbilical laparoscopy for pneumoperitoneum establishment: a comprehensive multicentre evaluation affirming safety, feasibility, and a range of clinical benefits

Antonia Rizzuto et al. Front Surg. .

Abstract

Introduction: Transumbilical laparoscopy (TUL) has emerged as a promising technique for establishing pneumoperitoneum in laparoscopic cholecystectomy, offering potential safety, feasibility, and clinical benefits. This retrospective multicentre study aims to evaluate the efficacy and outcomes of TUL in the management of gallbladder diseases.

Methods: A retrospective analysis was conducted on a cohort of 2,543 patients who underwent TUL between 2011 and 2021 across various medical institutions in Italy. Data collection included demographic, clinical, intraoperative, and postoperative parameters. Standardized protocols were followed for preoperative and postoperative management. The TUL technique involved precise anatomical incision and trocar placement.

Results: The study demonstrated favorable outcomes associated with TUL, including a low conversion rate to open surgery (0.55%), minimal intraoperative complications (0.16%), and short hospital stays (average 2.4 days). The incidence of incisional hernias was notably low (0.4%). Comparison with existing literature revealed consistent findings and provided unique insights into the advantages of TUL.

Discussion: Despite limitations, such as the absence of a control group and the retrospective nature of the study, the findings contribute valuable insights to the literature. They inform surgical decision-making and advance patient care in laparoscopic cholecystectomy for gallbladder diseases.

Conclusion: Transumbilical laparoscopy shows promise as a safe and feasible technique for establishing pneumoperitoneum in laparoscopic cholecystectomy. The study's findings support its clinical benefits, including low conversion rates, minimal complications, and short hospital stays. Further research, including prospective studies with control groups, is warranted to validate these results and optimize patient outcomes.

Keywords: incisional hernia; laparoscopic cholecystectomy; periumbilical laparoscopy; pneumoperitoneum insufflation; transumbilical laparoscopy (TUL).

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.

Figures

Figure 1
Figure 1
Identification of the deep point of the navel by gripping the upperside of the umbilical ring.
Figure 2
Figure 2
Longitudinal incision.
Figure 3
Figure 3
Suture of fascia and peritoneum in a single layer.
See this image and copyright information in PMC

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