Transumbilical single-access laparoscopic perforated gastric ulcer repair.

INTRODUCTION

In patients presenting with peritonitis, laparoscopy offers the possibility of diagnosis as well as treatment, with less abdominal trauma, reduced postoperative pain, and shorter hospital stay.

CASE REPORT: A 30-year-old woman, presenting with diffuse abdominal pain and free pneumoperitoneum, was submitted to transumbilical single-access laparoscopy. The procedure was performed using a standard 11-mm reusable trocar in the umbilicus and curved reusable instruments inserted transumbilically without trocars. The cavity exploration showed a perforated gastric ulcer at the anterior surface of the prepyloric area. A gastric suture repair, omentoplasty, and lavage of the cavity were performed.

RESULTS

The umbilical incision was 15 mm and laparoscopy lasted 86 minutes. Use of painkillers was minimal, and the patient was discharged on the fifth postoperative day. After 6 months, the umbilical scar was no visible.

CONCLUSIONS

Transumbilical single-access laparoscopy can be proposed in selected patients presenting perforated gastric ulcer, with the main advantage of improved cosmetic results.