title: Transumbilical laparoscopic surgery using GelPort through an umbilical zigzag skin incision.
abstract: BACKGROUND
  We report herein a new method of transumbilical laparoscopic surgery using a GelPort through an umbilical zigzag skin incision. The method involves collaborating with plastic surgeons to ensure the procedure was minimally invasive.
  
  
  METHODS
  After marking a zigzag skin incision in the umbilical region, the skin was incised along this line. Then, a GelPort double-ring wound retractor was inserted through the incision, which enlarged the diameter of the fascial opening to 6 cm. The Gelport was latched on the wound retractor ring, following the inflation of the pneumoperitoneum by CO (2). One or more additional ports were inserted as necessary. All operations were performed in the standard fashion. The specimen was easily extracted from the abdomen through the umbilical incision, and anastomosis was performed. Using the above method, we performed the following procedures: one total gastrectomy, one distal gastrectomy, three gastric local resections, five right hemicolectomies, two high anterior resections, three cholecystectomies, and seven transabdominal preperitoneal hernioplasties. All cases were accomplished without any complications using this method. The wounds of the umbilical region were almost "scarless" in all cases.
  
  
  CONCLUSIONS
  We developed an umbilical zigzag skin incision technique to perform abdominal laparoscopic operations using a GelPort, with a minimal number of skin incisions. We consider that our method reduces the technical difficulties associated with laparoscopic surgery and maintains cosmesis.
authors: Department of General Surgery, Yokkaichi Municipal Hospital, Japan. thachi88@yahoo.co.jp
authors: T
authors: T
authors: Hachisuka
authors: T
authors: T
authors: Kinoshita
authors: T
authors: T
authors: Yamakawa
authors: N
authors: N
authors: Kurata
authors: M
authors: M
authors: Tsutsuyama
authors: S
authors: S
authors: Umeda
authors: S
authors: S
authors: Tokunaga
authors: A
authors: A
authors: Yarita
authors: M
authors: M
authors: Shibata
authors: D
authors: D
authors: Shimizu
authors: T
authors: T
authors: Shikano
authors: K
authors: K
authors: Hattori
authors: T
authors: T
authors: Mori
authors: M
authors: M
authors: Shinohara
authors: M
authors: M
authors: Miyauchi
mesh_terms: D017081:Cholecystectomy, Laparoscopic / Q000295:instrumentation / Q000379:methods; D003082:Colectomy / Q000295:instrumentation / Q000379:methods*; D005743:Gastrectomy / Q000295:instrumentation / Q000379:methods*; D059685:Herniorrhaphy / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000295:instrumentation / Q000379:methods*; D014472:Umbilicus / Q000601:surgery*