Umbilical Quilting Suture Technique during Single-Port Laparoscopic Surgery

Abstract

Background and Objectives: Single-port laparoscopic surgery (SPLS) is popular in the gynecological field, because it is less invasive and leaves a smaller scar. However, the postoperative shape of the umbilicus is often distorted due to the intensive procedures performed through the small opening. In this report, we describe a technique for forming a satisfactory umbilicus in SPLS. Methods: From March 2016 through April 2017, 32 patients were treated with SPLS by a single gynecologic surgeon. Group A (14 cases) underwent conventional umbilicus closure, and group B (18 cases) underwent a quilting suture technique. The umbilical shapes of each group were assessed by a plastic surgeon as was the patients' satisfaction. Evaluations were performed immediately after surgery and every month for 6 months thereafter. Results: The postoperative umbilical shape in group A showed features, such as loss of depression, disappearance of the central vertical line, and irregularly bulging tissue, whereas group B had a shape similar to that of the natural umbilicus and maintained its depression and vertical line. The average scores of the plastic surgeons' evaluations immediately after the operation were 10.4 for group A and 15.1 for group B. The final scores obtained 6 months after surgery were 15.2 and 17.8, respectively. The patients' satisfaction scores immediately after the operation were 4.9 for group A and 7.3 for group B. The scores increased gradually, to 8.1 and 9.2, respectively, at 6 months after surgery. Conclusion: Performing quilting sutures during wound closure in SPLS is effective for making an ideal umbilicus and ensuring patients' satisfaction.