• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • COVID-19 Annoucements
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Advocacy
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2023 Scientific Session Call For Abstracts
      • 2023 Emerging Technology Call For Abstracts
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Past Meetings
      • SAGES 2022
      • SAGES 2021
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Video Based Assessments (VBA)
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • NEW-Area of Concentrated Training Seal (ACT)-Advanced Flexible Endoscopy-Coming Soon!
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Multi-Society Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • Store
    • “Unofficial” Logo Products
  • Log In

TU hidden scar surgery using GelPOINT through an umbilical zigzag skin incision

Takehiro Hachisuka, M D, Takashi Kinosita, M D, Nobuhiko Kurata, MD, Masayuki Tsutsuyama, MD, Shinnichi Umeda, MD, Akinaga Yaraita, MD, Seisaku Tokunaga, MD, Masahiro Shibata, MD, Toshio Shikano, MD, Keisuke Hattori, MD, Toshihiro Mori, MD, Masahiko Shinohara, MD, Tomomi Yamakawa, MD, Masayuki Miyauchi, MD. Department of Surgery and Plastic Surgery, Yokkaichi Municipal Hospital

 

INTRODUCTION) Hidden scar surgery is a new way in which surgeons perform abdominal operations through one incision made in the patient’s folds of umbilicus. The hidden scar approach is the latest advancement in minimally invasive surgery. However, with a straight incision of the umbilicus, the opening of fascia is maximally 2cm. The 2-cm fascial opening is not enough to keep the triangulation of instruments, remove specimens and do anastomosis, particularly in gastrectomy and colectomy. To overcome this problem, we developed an umbilical zigzag skin incision with a 6-cm opening of fascia and peritoneum in collaboration with plastic surgeons and used Gelport® to keep pneumoperitoneum, which finally resulted in scarless wound1) This technique is a modification of umbilicoplasties for umbilical deformities by plastic surgeons2,3). We have already experienced 24 abdominal operations including 1 total gastrectomy, 1 distal gastrectomy, 3 gastric local resections, 5 right hemicolectomies, 3 high anterior resections, 4 cholecystectomies, and 7 transabdominal preperitoneal hernioplasties (TAPP) . Meanwhile, for hidden scar surgery, GelPOINT® (Applied Medical, Rancho Santa Margarita, CA, USA), was developed to maintain triangulation, fulcrum and pneumoperitoneum during the laparoscopic procedure. The product was available in Japan this year and used to many procedures through our umbilical zigzag incision in our institution.
We report herein our new method of transumbilical laparoscopic surgery (TULS) using GelPOINT® through an umbilical zigzag skin incision.
METHODS AND PROCEDURES) After marking a zigzag skin incision in the umbilical region, the skin was incised along this line. Then, a GelPOINT® ’s double-ring wound retractor was inserted through the incision, which enlarged the diameter of the fascial opening to 6 cm. Its GelSeal® cap was latched on the wound retractor ring, following inflation of the pneumoperitoneum by CO2. 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.
RESULTS) Using the above method, we performed the following:1 right hemicolectomy, 1 high anterior resection, 2 cholecystectomies, and 2 transabdominal preperitoneal hernioplasties (TAPP). All cases were accomplished by this method without any complications. The wounds of the umbilical region were almost “scarless” in all cases.
DISCUSSION) We developed an umbilical zigzag skin incision technique to perform abdominal laparoscopic operations using GelPOINT® with a minimal number of skin incisions. We consider that our method is one new way to lessen the technical difficulties of “hidden scar” laparoscopic surgery and keep cosmesis for scarless wounds.
REFERENCES)
1. Hachisuka T, Kinoshita T, Yamakawa T et al. Transumbilical laparoscopic surgery (TULS) using Gelport® through an umbilical zigzag skin incision. Asian Journal of Endoscopic Surgery, in press
2. Kajikawa A, Ueda K, Sakaba T et al. (2010) Umbilicoplasty for type of umbilical deformities. Plast Reconstr Surg 125(6):263e-264e
3. Bruekers SE, van der Lei B, Tan TL, Luijendijk RW, Stevens HP (2009) “Scarless”
umbilicoplasty: a new umbilicoplasty technique and a review of the English
language literature. Ann Plast Surg 63(1):15-20


Session Number: Poster – Poster Presentations
Program Number: P509
View Poster

228

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

« Return to SAGES 2012 abstract archive

Our Mission

Innovate, educate and collaborate to improve patient care.

Recently, on SAGES…

Critical View of Safety (CVS) Challenge QR Code

The SAGES Critical View of Safety Challenge – Donate Your Lap Chole Videos!

The Society of American Gastrointestinal and Endoscopic Surgeons is hosting the first Artificial Intelligence Data Challenge conducted by surgeons. The aim of this challenge is to generate a large and diverse dataset of laparoscopic cholecystectomy videos, annotated with respect to the subcomponents of the Critical View of Safety (CVS). Computer scientists from all over the […]

Respuesta de SAGES al Estudio NordICC sobre el beneficio de las colonoscopias de detección

SAGES desea aclarar los resultados del estudio NordICC y colocarlos en contexto de los esfuerzos de varias agencias nacionales para reducir el riesgo de cáncer colorrectal – la segunda causa de muerte por cáncer más frecuente en los Estados Unidos-, mediante la promoción de la detección y tratamiento oportuno de las lesiones.

SAGES Response to NordICC Study Regarding Benefit of Screening Colonoscopies

The NordICC Study recently published in The New England Journal of Medicine and widely reported on by media outlets has raised questions regarding the benefit of screening colonoscopy in lowering the risk of colorectal cancer and cancer-related deaths among otherwise healthy and symptom-free men and women aged 55 to 64. Provocative headlines and commentaries have […]

Contact SAGES

Society of American Gastrointestinal and Endoscopic Surgeons
11300 W. Olympic Blvd Suite 600
Los Angeles, CA 90064 USA
webmaster@sages.org
Tel: (310) 437-0544

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2023 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2023 Society of American Gastrointestinal and Endoscopic Surgeons