Transumbilical approach for neonatal surgical diseases: Woundless operation

Tatsuro Tajiri, Satoshi Ieiri, Yoshiaki Kinoshita, Kouji Masumoto, Yuko Nishimoto, Tomoaki Taguchi

Research output: Contribution to journalArticlepeer-review

28 Citations (Scopus)


Purpose: The transumbilical approach by means of a circumumbilical incision has up until recently been the main method for performing a pyloromyotomy. This study aims to assess the clinical usefulness of the transumbilical approach for neonates with a variety of surgical intraabdominal diseases in order to achieve minimally invasive surgery with excellent cosmetic results. Methods: In 14 neonates with surgical diseases (3 hypertrophic pyloric stenoses, 3 ileal atresias, 2 jejunal atresias, 1 duodenal stenosis, 1 duodenal atresia, 2 ovarian cysts, 1 malrotation, and 1 segmental dilatation of ileum), treatment using a transumbilical approach by means of a half circumumbilical incision was performed at our institution. The clinical features of 14 cases were evaluated. Results: Eight cases except for three patients with hypertrophic pyloric stenosis, two with ovarian cysts and one with intestinal malrotation underwent the operation within 4 days of birth. In 10 of 14 cases, the umbilicus was incised on its upper half circumference, while the umbilicus of 4 cases was incised on its lower half circumference. In one ileal atresia patient with a remarkable degree of oral intestinal dilatation, a slight additional transverse incision was added. In four cases (1 case with ileal atresia, 2 cases of an ovarian cyst, and 1 case with a segmental dilatation of the ileum), laparoscopy-assisted transumbilical surgery was performed. In all cases, no operative complications were encountered. Postoperatively, there was no wound in appearance and the umbilicus appeared to be normal. Conclusion: The transumbilical approach with or without laparoscopic assistance is considered to be a feasible, safe, and cosmetically excellent surgical procedure in neonates with a wide variety of surgical intraabdominal diseases.

Original languageEnglish
Pages (from-to)1123-1126
Number of pages4
JournalPediatric surgery international
Issue number10
Publication statusPublished - Oct 2008

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Surgery


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