Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of General Surgery

The umbilicus is the main access route to the abdominal cavity in laparoscopic surgeries. However, its anatomical configuration is rarely studied in the surgical and anatomical literature. With introduction of laparoscopic single-site surgery and considering the significant number of primary and postoperative umbilical hernias, we felt the necessity to comprehensively study the umbilical structures and detect the incidence of umbilical defect. This study included one hundred and sixtypeople,one hundred and forty four ofthem having umbilical defect and the other sixteen percent haven{u2019}t. By using of laparoscopic camera from inside the abdomen and a camera from outside the abdomen. The current study results suggest that: presence of umbilical defect was natively found in population as ninety percent of the people having the defect.Comparing cases with Skandalakis that found ,The umbilical opening is usually inferiorly reinforced by the attachments of the median umbilical ligament (the obliterated urachus) and the paired medial umbilical ligaments (the obliterated umbilical arteries) and is more weakly superiorly reinforced by the round ligament (the obliterated umbilical vein) .Comparing cases with Salameh said that, after vertically splitting the skin of the umbilicus till the depth of cicatrix , we found ourselves inside a defect which described as umbilical ring that previously sealed by parietal peritoneum. Interestingly the incidence of the umbilical defect that previously described as umbilical ring we found matching the incidence of the acquired true umbilical hernia.Using the statistical package SPSS (Statistical Package for the Social Sciences) version24 there was a statistically no significant difference between the presence of the umbilical defect and patients , age, sex, BMI, chronic use of steroids, other hernias nor weak mesenchyme

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