title: Avoidance of tattoo disruption: a further benefit of laparoscopic surgery.
abstract: BACKGROUND
  Tattoos are increasingly common in both male and female patients. Abdominal skin tattoos may be present at the site of proposed incisions for conventional surgery whereas laparoscopic port site placement can be adjusted to accommodate tattoo constraints.
  
  
  METHODS
  Patients with tattoos were questioned by face-to-face interview to determine how long ago they had their tattoo, financial cost of the tattoo, and potential degree of distress caused by disruption of their tattoo (on a scale of 1-10). Consultant and higher surgical trainee general surgeons were asked by e-mail survey whether they had encountered a patient with a tattoo at the site of a proposed incision, did they avoid incising the tattoo during surgical intervention, and had they received a complaint from a patient about tattoo distortion.
  
  
  RESULTS
  Ninety six patients (50 male, median age 29 years) were questioned. Median cost of the tattoos was pound35 ($70). Female patients were more likely to be distressed and complain than men about tattoo disruption (p = 0.0003) and there was a significant inverse correlation between time from tattooing and distress (p = 0.02). Most (79%) of the general surgeons questioned (n = 107, response rate 82%) had encountered tattoos at proposed incision sites; 61% had avoided making an incision through it and 4% had received a complaint about tattoo disruption by a patient.
  
  
  CONCLUSIONS
  Tattoo disruption by surgical incision may cause distress especially in female patients who had their tattoo recently. Tattoos should be avoided where possible by alternative port site placement.
authors.affiliation: James Cook University Hospital, Marton Road, Middlesborough, TS4 3BW, UK. andrewgilliam@btinternet.com
authors.forename: A D
authors.initials: AD
authors.lastname: Gilliam
authors.forename: L
authors.initials: L
authors.lastname: Donnelly
authors.forename: B
authors.initials: B
authors.lastname: Gopinath
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D005260:Female; D013502:General Surgery; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D010535:Laparoscopy; D008297:Male; D017060:Patient Satisfaction; D011183:Postoperative Complications; D012737:Sex Factors; D013315:Stress, Psychological / Q000209:etiology*; D013653:Tattooing / Q000191:economics / Q000523:psychology