title: Prevalence of infraumbilical adhesions in women with previous laparoscopy.
abstract: OBJECTIVE
  The aim of this study is to evaluate the prevalence of intraabdominal adhesions to the umbilicus following gynecologic laparoscopy through an umbilical incision.
  
  
  METHODS
  A retrospective review was performed of all gynecologic laparoscopic procedures in a private practice setting to identify patients with a repeat laparoscopy who had a history of a previous laparoscopy through an umbilical incision. Patients with a history of other surgeries were excluded. All repeat laparoscopies used a left upper quadrant entry technique where the abdominal cavity was surveyed for adhesions. We also reviewed adverse events attributable to the left upper quadrant entry approach.
  
  
  RESULTS
  We identified 151 patients who underwent a second laparoscopy and had a previous umbilical scar. Thirty-two of the 151 (21.2%) patients with a history of a laparoscopy had evidence of adhesions to the umbilical undersurface. No adverse events or injuries were attributed to the left upper quadrant entry technique.
  
  
  CONCLUSIONS
  Adhesions to the umbilical undersurface occur in 21.2% of patients who have undergone a prior laparoscopy through an umbilical incision. For this reason, we recommend an alternate location for entry in patients with an umbilical scar from a previous laparoscopy.
authors.affiliation: University of Texas Medical Branch, Department of Obstetrics and Gynecology Galveston, Texas 77555, USA. vsepilian@chairf.com
authors.forename: Vicken
authors.initials: V
authors.lastname: Sepilian
authors.forename: Lowell
authors.initials: L
authors.lastname: Ku
authors.forename: Herb
authors.initials: H
authors.lastname: Wong
authors.forename: C Y
authors.initials: CY
authors.lastname: Liu
authors.forename: John Y
authors.initials: JY
authors.lastname: Phelps
mesh_terms: D000005:Abdomen / Q000473:pathology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D008875:Middle Aged; D012086:Reoperation; D000267:Tissue Adhesions / Q000209:etiology