An infraumbilical incision is a horizontal surgical cut made into the depression of the belly button, or umbilicus. Several types of surgeries use this type of incision, including an appendectomy, a gallbladder removal surgery, and a bilateral tubal ligation. It may also be used to access the bladder, intestines, and the prostate gland. The location of this incision makes it useful for emergency abdominal surgeries, as it allows the surgeon to access both sides of the abdominal cavity quickly.
Before the surgeon creates the infraumbilical incision, the patient will be put under anesthesia. Most anesthesia is administered through an intravenous (IV) line inserted into the patient’s arm in the pre-operation process. The first medication given is used to relax the patient, and then the anesthesia medications are added to the IV line throughout the surgery.
When this type of incision is used during an operation, the surgeon will often need to stand in between the patients legs to access the surgical site. A specially shaped operating table allows the patient’s legs to be placed in an open V position during the surgery. Standing on the other side of the patient’s legs, the surgery techs are able to provide the surgeon with instruments and supplies without interfering with the procedure.
During laparoscopic procedures, a single infraumbilical incision can be used to insert multiple surgical instruments. The surgical instruments are inserted into the opening one at a time, or may be layered over one another as the operation progresses. This single port incision is often used to reduce the amount of scarring and pain that occurs after surgery. Some patients may not be suitable candidates for the use of a single incision; many pediatric patients and people that are overweight may need more than one port of entry to ensure the success of the laparoscopic surgery.
Complications from the use of the infraumbilical incision are varied. The most common problem reported after an infraumbilical incision has been used is an infection of the umbilicus. Some patients have developed umbilical adhesions after the tissue heals. The abdominal wall tissue grows into the umbilicus, causing the tissue to band together. These adhesions may need to be surgically separated if the patient reports that they are causing pain during movement.
Additionally, the close proximity of the umbilicus to the linea alba, the line that separates the rectus abdominis muscles, makes the tissue near the incision site thinner than the surrounding tissue of the abdomen. This may increase the risk of a hernia forming on the incision site. The thinner skin may also increase the possibility of complications caused by the sutures bursting during vigorous activity.