Transumblical versus Infraumblical pneumoperitoneum: A comparative study.

Abstract

Objectives: In Laparoscopic surgery placement of primary port is an important step and is often associated with complications. Our objective is to compare the merits and demerits like safety, efficacy of the site, time of entry of the port, per-operative and post-operative complications of infrumbilical (IU) with transumbilical (TU) approach for placement of this port. So on the basis of best clinical evidence get a clinical direction for a better site for placement of primary port. Study Design: A prospective randomized controlled trial of 238 patients. Setting: Surgical unit II of DHQ Hospital/ Sargodha Medical College (University of Sargodha) Sargodha. Period: June 2015 to December 2017. Material & Methods: Patients aged 16-70 years, fit for surgery, under general anesthesia were included in this study after informed consent. Patients who were unfit for general anaesthesia, who were Imuno-compromised, diabetics, CLD, with ascites, patients with suspected malignancy, with previous surgery in the umbilical region like midline laparotomy scar, previous hernia repair in this region were excluded from this study. Permission was sought from and granted by institutional ethical committee. Results: A total number of 238 patients were included. Group A (Trans-Umbilical) and Group B (Infra-Umbilical) contained 119 cases each. There were 147 female and 91 male. (M: F ratio of 1: 1.615). Conclusion: Based on results from this study and previous literature, it may be concluded that Transumbilical (TU) placement of primary port for creation of pneumoperitoneum is superior to infrumbilical (IU) approach.