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

Background: 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. Methods: 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 the Wilcoxon test. Results: Complete healing of the new umbilicus was achieved in 14-21 days in nine cases. In one case, partial dehiscence of the wound occurred and complete healing was achieved in 4 weeks. Follow-up time ranged from 1 to 4 years. In all patients, a three-dimensional umbilicus with satisfactory depression was created. During follow-up, no significant changes in shape, dimension and appearance were observed. All patients were pleased with the results. No cicatricial umbilical stenosis occurred. Conclusions: The double opposing "Y" technique creates a new natural umbilical scar; this technique can be easily performed for umbilical reconstruction after omphalectomy.