EP-29 The prevalence of a small occult umbilical hernia during the trans-umbilical approach in general laparoscopic surgery

Abstract

Abstract Aims The aim of this study was to firstly determine the prevalence of a small occult umbilical hernia during the trans-umbilical incision technique in general laparoscopic surgery. Secondly, to determine patient satisfaction with post-operative pain and cosmesis. Methods This was a prospective study of 128 patients who underwent a trans-umbilical incision during general laparoscopic surgery by a single surgeon between January 2020 and July 2021. Demographic data, type of surgery, presence of small occult umbilical hernia, time to gain access and time of incision closure were obtained from the operation note. Following the procedure each patient was contacted via telephone and asked questions regarding, post-operative pain, surgical site infection, post-operative complications and cosmetic satisfaction. Results Of the 128 patients within the study, 57.8% were female with a mean age of 44.4 years and a BMI of 26.6 kg/m2. The most common operation performed was laparoscopic cholecystectomy in 51.6% of patients. 62.5% of patients were found to have the presence of a small occult umbilical hernia with a mean of 1.1 minutes to gain access and 6 minutes to close incision. Approximately, 80% of patients stated that post-operative pain experienced was as or less than expected. All patients were satisfied with scar cosmesis. Conclusion Well over half of patients were found to have a naturally occurring small umbilical hernia that could make gaining access to the abdominal cavity via a trans-umbilical incision easier, quicker and safer. As well as excellent patient satisfaction with regards to scar cosmesis and lower than expected post-operative pain scores.