Comparison of transumbilical and periumbilical median incisions in ovarian cancer surgery

The umbilicus is traditionally circumvented while performing a vertical midline abdominal incision. There is a gap in knowledge pertaining to avoiding the umbilicus. Our aim was to determine whether transumbilical or periumbilical midline incision conferred any advantage to the patient.This is a retrospective cohort study of patients who underwent ovarian cancer surgery with a midline incision, from the pubic tubercle to the xiphoid. All of the surgeries were performed by the same group of gyneacological oncologists. Patients were classified into two groups according to the type of midline incision, transumbilical or periumbilical. The primary endpoint was the wound complication rate of the incisions.Transumbilical and periumbilical midline incisions were performed on 54 and 68 patients, respectively. There were no differences between the two groups in terms of patient characteristics and operative details. The two groups had comparable rates of complications including wound infection (7.4% vs 10.3%, p= 0.75), deep surgical site infection (11.1% vs 4.4%, p= 0.18), evisceration (3.7% vs 4.4%, p= 0.99) and incisional hernia (33.3% vs 33.8%, p= 0.99).According to our findings, circumventing the umbilicus during laparotomy did not have any advantage. Future prospective randomized trials are warranted to confirm it.