Biopsy proven umbilical metastasis originating from an unknown intra-abdominal cancer in a post menopausal woman. She did not recall any invasive intervention through umbilicus. But it may supposedly complicate a diagnostic or staging laparoscopy.
Trocar placement for cholecystojejunostomy. If you plan to do a gastrojejunostomy as well, modify the trocar placement as shown later (Fig. 36.4). In each case, trocar placement must be individualized. A standard umbilical or subumbilical location for tro