Annals of Surgery

Skip Navigation LinksHome > January 2014 - Volume 259 - Issue 1 > Wound Complications in 1145 Consecutive Transumbilical Singl...
Annals of Surgery:
doi: 10.1097/SLA.0b013e31827b7818
Original Articles

Wound Complications in 1145 Consecutive Transumbilical Single-Incision Laparoscopic Procedures

Weiss, Helmut G. MD, MSc*; Brunner, Walter MD, BA*; Biebl, Matthias O. MD*,†; Schirnhofer, Jan MD*; Pimpl, Katharina MD*; Mittermair, Christof MD*; Obrist, Christian MD*; Brunner, Eberhard MD*; Hell, Tobias MSc

Collapse Box


Objective: To evaluate the wound complication rate in patients undergoing transumbilical single-incision laparoscopic (SIL) surgery.

Background: SIL surgery claims to be less invasive than conventional laparoscopy. Small SIL series have raised concerns toward a higher wound complication rate related to the transumbilical incision.

Methods: In a 44-month period, 1145 consecutive SIL procedures were included. The outcomes were assessed according to the intention-to-treat analysis principle. All procedures were followed for a minimum of 6 months postoperatively, and wound complications were recorded as bleeding, infection (superficial/deep), or hernia. Patients were classified as having a wound complication or not. For all comparisons, significance level was set at P < 0.05.

Results: Pure transumbilical SIL surgery was completed in 92.84%, and additional trocars were used in 7.16%. After a median follow-up of 22.1 (range, 7.67–41.11) months, 29 wound complications (2.53%) had occurred [bleeding 0%/infection 1.05% (superficial 0.9%/deep 0.17%)/early-onset hernia 0.09%/late-onset hernia 1.40%, respectively]. Factors associated with complications were higher patient body mass index (28.16 ± 4.73 vs 26.40 ± 4.68 kg/m2; P = 0.029), longer skin incisions (3.77 ± 1.62 vs 2.96 ± 1.06 cm; P = 0.012), and multiport SIL versus single-port SIL (8.47% vs 2.38%; P = 0.019) in complicated versus uncomplicated procedures. Furthermore, a learning curve effect was noted after 500 procedures (P = 0.015).

Conclusions: With transumbilical SIL surgery, the incidence of wound complications is acceptable low and is further reduced once the learning curve has been passed.

© 2014 by Lippincott Williams & Wilkins.


Article Tools


Article Level Metrics

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.