The Comparison of Postoperative Pain Between Umbilical and Suprapubic Incision in Laparoscopic Liver Resection

Abstract

Introduction: In laparoscopic hepatectomy, wounds for specimen removal are indispensable. The umbilical incision is commonly used in laparoscopic colectomy and is familiar to gastroenterologists. On the other hand, it has been pointed out that the suprapubic incision method, which is often performed in the gynecological surgery, is superior in terms of postoperative pain, but there is no report comparing the two. Method: From November 2007 to May 2019, 19 patients who underwent laparoscopic lateral segmental resection at our hospital under complete arthroscopy were included. In 11 patients with umbilical incision and 8 patients with suprapubic incision, the operation time, bleeding volume, wound length, duration of continuous intravenous fentanyl infusion immediately after surgery and the number of flushes, and period of regular oral administration of NSAIDs were evaluated. Results: There was no significant difference between the two groups in terms of patient background, age, operation time, and bleeding volume. However, suprapubic incision was significantly longer in wound length than in umbilical incision. Subsequently, for postoperative pain, the duration of continuous intravenous fentanyl administration was 1 day (1-2 days) for umbilical incisions and 1.5 days (1-2 days) for suprapubic incisions, with no significant difference. About the number of fentanyl, the result was comparable. In the period of regular NSAIDs administration, there was also no significant difference with POD14 (POD5-35) in umbilical incisions and POD8 (POD7-32) in suprapubic incisions. Conclusions: In laparoscopic hepatectomy, extirpation of the specimen by umbilical incision is acceptable.