title: Does transumbilical incision increase incisional hernia at the extraction site of laparoscopic anterior resection?
abstract: BACKGROUND
  It is unclear whether transumbilical incision for laparoscopic colectomy has a risk of incisional hernia at the extraction site similar to left lower incision.
  
  
  METHODS
  Consecutive patients who underwent laparoscopic sigmoid plus high and low anterior resection between August 2008 and February 2011 were included in the study. Incision for specimen extraction was changed from left lower to transumbilical incision in February 2010. The main outcome was the incidence of incisional hernia diagnosed by computed tomography.
  
  
  RESULTS
  One hundred and eighty-six patients underwent laparoscopic anterior resection (94 transumbilical incisions and 92 left lower transverse incisions). Three percent of patients had an incisional hernia at the extraction site, and the incidence of this phenomenon was not significantly different between the 2 groups. Surgical wound infection was lower in the transumbilical incision group than in the left lower incision group.
  
  
  CONCLUSIONS
  Extraction site for transumbilical incision may not affect the risk of incisional hernia.
authors.affiliation: Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama 350-1298, Japan. Electronic address: y_morita@saitama-med.ac.jp.
authors.forename: Yohei
authors.initials: Y
authors.lastname: Morita
authors.affiliation: Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama 350-1298, Japan.
authors.forename: Shigeki
authors.initials: S
authors.lastname: Yamaguchi
authors.affiliation: Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama 350-1298, Japan.
authors.forename: Toshimasa
authors.initials: T
authors.lastname: Ishii
authors.affiliation: Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama 350-1298, Japan.
authors.forename: Jo
authors.initials: J
authors.lastname: Tashiro
authors.affiliation: Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama 350-1298, Japan.
authors.forename: Haruka
authors.initials: H
authors.lastname: Kondo
authors.affiliation: Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama 350-1298, Japan.
authors.forename: Asami
authors.initials: A
authors.lastname: Suzuki
authors.affiliation: Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama 350-1298, Japan.
authors.forename: Kiyoka
authors.initials: K
authors.lastname: Hara
authors.affiliation: Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama 350-1298, Japan.
authors.forename: Isamu
authors.initials: I
authors.lastname: Koyama
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy / Q000379:methods*; D003110:Colonic Neoplasms / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006555:Hernia, Ventral / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D012004:Rectal Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014472:Umbilicus / Q000601:surgery*
keywords: Incisional hernia; Laparoscopic colectomy; Transumbilical incision