Supraumbilical incision with U-u umbilicoplasty for congenital duodenal atresia: the Stockholm experience.
BACKGROUND
Minimizing scars has become a major concern in pediatric surgery. Since Tan and Bianchi introduced the minimally invasive umbilical incision for Ramstedt's pyloromyotomy, their technique has been adopted for a variety of neonatal abdominal conditions. The aim of this study was to evaluate a modification of the skin incision.


METHODS
We have modified Bianchi's original technique to access the abdomen through the linea alba by introducing a novel U-to-u umbilicoplasty and compare the results with the traditional transverse incision. This new approach improves the abdominal access and is easy to perform.


RESULTS
The operating time with the U-to-u umbilicoplasty is not longer than in standard transverse laparotomy, the access to the abdomen is more than adequate, the incidence of postoperative complications is similar and the cosmetic results are excellent.


CONCLUSIONS
We conclude that the umbilical approach with this novel U-to-u umbilicoplasty to treat congenital duodenal obstruction in the newborn is a safe and effective method and a good alternative to the standard transverse laparotomy approach.
Department of Pediatric Surgery, Astrid Lindgren's Children's Hospital, Karolinska University Hospital, Stockholm, Sweden; Department for Women and Children's Health, Karolinska Institutet, Stockholm, Sweden.
Nader
N
Ghaffarpour
Pär-Johan
PJ
Svensson
Anna
A
Svenningsson
Tomas
T
Wester
Carmen
C
Mesas Burgos
D002921:Cicatrix / Q000517:prevention & control*; D004314:Down Syndrome; D004380:Duodenal Obstruction / Q000151:congenital / Q000601:surgery*; D004385:Duodenostomy / Q000379:methods; D004954:Esthetics; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007409:Intestinal Atresia; D007813:Laparotomy / Q000379:methods*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D061646:Operative Time; D011183:Postoperative Complications / Q000517:prevention & control*; D012189:Retrospective Studies; D013536:Suture Techniques; D013548:Sweden; D014472:Umbilicus / Q000601:surgery*
Congenital duodenal atresia; Minimally invasive surgery; Neonatal surgery; Umbilical incision; Umbilicoplasty