Umbilical Reconstruction in Children: A Simplified Operative Technique (original) (raw)

Umbilical Reconstruction Techniques: A Literature Review

Aesthetic Plastic Surgery, 2020

Background There are many instances in which sacrificing the umbilicus is unavoidable. Umbilical reconstruction (umbiliconeoplasty) is an important surgical procedure to complete the abdomen's reconstruction and to give again a pleasant cosmetic appearance. Objectives To provide a complete overview of all surgical techniques for umbiliconeoplasty described in the literature. Methods PubMed database was queried using 'umbilical and reconstruction', 'umbilicus and reconstruction', 'navel and reconstruction', 'umbiliconeoplasty', 'neo-omphaloplasty' or 'umbilicaneoplasty' to select the papers dealing with the reconstruction of the umbilicus. Results Sixty different techniques for the reconstruction of the missing umbilicus were described in 77 papers. Local skin flaps and the purse-string suture technique were the most frequently described techniques. The Three flaps technique, the Four flaps technique and the 2 Lateral rectangular pedicle lateral flaps technique were the most popular local flap techniques. Indications ranged from congenital pediatric defects to reconstruction during abdominoplasty. Conclusions Several surgical techniques were described for umbilicus reconstruction. While there is not a universal algorithm for the choice of the technique, the surgeon may decide which technique to use based on other surgeons' experiences reports.

A New Method for Umbilicus Reconstruction: Preliminary Report

Aesthetic Plastic Surgery, 2006

The umbilicus is a very important component of the abdominal aesthetic view. However, loss of the umbilicus for any reason is a challenging problem. Various methods for umbilicus reconstruction have been published. Most of these methods are complex, and the surgical outcome is mostly unsatisfactory for the patients. The authors have developed a simple method for umbilicus reconstruction using a bilobed flap.

Umbilical Reconstruction for Patients with a Midline Scar

Aesthetic Plastic Surgery, 2006

The authors describe an approach to neo-umbilicoplasty for patients with vertical midline scars and those who have undergone extensive tegumental resections after bariatric surgery. Two lateral pedicle flaps sutured to each other are used to shape a cutaneous wall tube in which the inverted end is anchored to the aponeurotic plane. A navel cavity of adequate scoop is shaped with no surrounding scar, in addition to relief of the strain along the vertical scar, which will be less prone to hypertrophy and will have a better cosmetic appearance. This article presents seven cases of umbilical reconstruction using this technique.

Umbilical reconstruction with the bow tie flap

European Journal of Plastic Surgery, 2016

The umbilicus can be absent in congenital malformations that are associated to umbilical agenesia such as bladder exstrophy, gastroschisis or omphalocele or it can be excised during surgical procedures such as umbilical herniorrhaphy, abdominoplasty and laparotomy. We report a new technique for umbilical reconstruction, using a Bbow tie^-shaped flap, partially made of scar tissue. We treated three female patients with absent umbilicus as a consequence of congenital malformations or previous surgical treatments. This method provided a good conical shape to the neoumbilicus with adequate depth and a wide external ring. Follow-up at 2 years showed that a satisfactory shape was maintained. Previously described techniques for neoumbilicoplasty were unsatisfying or seemed too complex in our hands. The reported technique is easy and simple, with good, stable and natural aesthetic results, and it can be effectively used for umbilical reconstruction in all primary or secondary cases of umbilical absence. Level of evidence: Level V, therapeutic study.

Emulation of a Newborn’s Umbilical Scar

2018

Background: Since the early ages of modern abdominoplasty, surgeons have paid special attention to the aesthetic aspects of the umbilicus. Studies have reported a variety of efforts to recreate a natural-looking belly button. This chapter presents another approach in this surgical field, which emulates the natural healing course of a newborn’s navel.

A new umbilicoplasty technique for the management of large umbilical hernia in children

hernia, 2019

Background The ideal technique for reconstruction of proboscoid umbilical hernia in children is the subject of ongoing researches. The aim of this study is to describe our umbilicoplasty technique in the surgical repair of proboscoid umbilical hernia and report its results. Methods The study included 21 children presented with a proboscoid umbilical hernia from 2014 to 2018. All patients had umbilicoplasty by the following technique: skin incisions were marked then a circular incision was made starting near the umbilical scar. We repaired the fascial defects then excised the lateral twin isosceles triangular flaps. A new umbilical depression was created by subcutaneous sutures fixing the center of the umbilical scar to the aponeurosis. We evaluated the results of surgery as excellent, fair or bad based on the criteria of the peripheral rim (raised, flattened or depressed); in addition to the central depression (deep, shallow or absent). Results The study included 12 boys (57%) and the age ranged from 19 to 67 months. The mean duration of the procedure was 45 min and the mean hospital stay was 1 day. All patients had excellent early results and after 12 months follow-up, the umbilicus was naturally looking and had an excellent peripheral rim and a central depression. Conclusion The described umbilicoplasty technique in the surgical repair of proboscoid umbilical hernia in children is simple and easy with excellent aesthetic results.

The Two-Dermal-Flap Umbilical Transposition: A Natural and Aesthetic Umbilicus after Abdominoplasty

Plastic and Reconstructive Surgery, 2007

Background: The aesthetic and natural appearance of the transposed umbilicus after abdominoplasty is a key factor to the overall result and satisfaction of patient and surgeon alike. In this article, the authors present a technique in umbilical transposition that creates a natural-appearing umbilicus. Methods: The skin in the neoumbilical position is deepithelialized and incised in the midline, thus creating two dermal flaps that are sutured down to the abdominal fascia, thereby creating a natural periumbilical concavity, inconspicuous scars, and a tension-free closure, resulting in a decreased chance for cicatricial umbilical scarring. Twenty patients underwent umbilical transposition during abdominoplasty with this technique between 2003 and 2005. Results: Both patient and surgeon satisfaction were very high, with three senior surgeons changing their surgical technique after being introduced to that described in this article. One complication culminated in partial skin dehiscence early in our experience when deep dermal sutures were not used for skin closure. Conclusion: The technique described is simple, safe, and easily learned, and results in a very satisfying aesthetic and natural-appearing umbilicus in patients after abdominoplasty.

Umbilical restoration in abdominoplasty A simple rectangular technique

Aesthetic Surgery Journal, 2003

Background: Many surgical procedures for reconstructing the umbilicus during dermolipectomy have been described. Objective: The authors present a simple technique for umbilicus restoration in abdominal dermolipectomy to improve the shape of the umbilicus and disguise the periumbilical scar. Methods: A skin incision was made to free the umbilicus from its original position. Two fixation points, at the 6-o'clock and 12-o'clock positions, 5 mm under the margin of the umbilicus, were employed to attach the umbilicus to the aponeurosis of the linea alba and the xiphoumbilical line, respectively. The index finger was inserted through the lower abdominal incision, after which the location of the umbilicus was palpated and marked on the abdominal skin 0.5 cm under the projected position of the neoumbilicus. A rectangle was drawn on the abdominal skin, marking the neoumbilical position. After skin incision around the neoumbilical position, subcutaneous fat was removed with scissors. Results: From February 1999 to June 2003, the procedure was performed in 142 patients, with good results and only minor complications. Conclusion: The rectangular technique for restoration of the umbilicus is a simple, successful, and safe procedure.

The double opposing "Y" technique for umbilical reconstruction after omphalectomy

Annali italiani di chirurgia

Abdominal surgical procedures, such as ventral hernia repair, may require the removal of the umbilicus, which gives an unnatural appearance to the abdomen. This situation can be corrected by umbilical reconstruction during the same operative time or at a later stage. In previous studies, we reported a versatile technique for umbilicoplasty based on a double opposing "Y" incision on the abdominal flap to create a new umbilicus. We now report the use of this technique for umbilical reconstruction in patients who underwent previous or concurrent omphalectomy. A prospective open-label study was performed on 10 patients undergoing the double opposed "Y" umbilicoplasty after omphalectomy. Postoperative patients' satisfaction and results were evaluated during the follow-up of minimum 1 year. A modified 5 ml syringe was used to assess depth and volume of umbilical stalk. Depth value variations from one month to one year after surgery were statistically compared using...