The umbilicus is a good choice--the skin and subcutaneous tissue can be undermined and raised to hide the incision made on the linea alba or rectus sheath

Thank you, Dr. Zacharian. Our technique is a preceding umbilical hidden-scar incision technique by plastic surgeon's idea. It is very easy to do and cosmetically perfect! Also, it gived surgeons a good feeling when they remove the specimen just after all procedures are done.

Yes i do agree

although i also think that umblical incision is a good and cosmetic choice, i prefer tu use a pfannenstiel incision, but in the classic way; I do it left from midline, right above the sigmoid, without cutting any muscle, only rectus sheath, then I put aside the rectus muscle. the result is very good, with minimal pain and risk of hernia formation, as no muscle is cut. and also the scar is always hidden.

for right colectomies, i still use umbilical incision.

Agree, umbilical incision is ideal cosmetically.Did anybody compare the incidence of incisional hernia.Personally my opinion is pfnensttiel incision is a better option as the incidence of inc hernia is practically nil.

"Pｒｅｃｅｄｉｎｇ'' is important in our technique. The openig for organ removal is also used for surgical procedures, resulting in the port reduction.

A photo of a patient who underwent laparoscopic sigmoidectomy by an umbilical zigzag skin incision technique 1 year ago. Can you see the scar? Almost invisible! In this case, we used only one additional port in the right lower abdomen.

Dr. Hachisuka,

That is great result you have achieved!

Dear Dr. M Rangarajan,

Thank you for your answer.

Please try it in your department and send your impression.

T. Hachisuka, MD

I think I will. Thanks