Should we all be refusing the umbilical entry?
I’ve reviewed clinical data (including JMIG and Obstetrics & Gynecology). If anything here is outdated, I’m open to correction, but it will not change my decision to refuse umbilical entry.
I’m not trying to say with my found information that umbilical entry is always wrong. It’s not, think about the women suffering from umbilical endometriosis! (But umbilical entry can also cause this) But in this case, it appears to be (due to all information I tried to summarise here): it’s an unnecessary risk, and patients are often ill informed due to it being basic protocol.
so let’s inform ourselves!
This is how I understand it:
Complication and failure rates
Studies (2025) report complication rates of 5.8% for umbilical entry vs 1.8% for Palmer’s Point
The majority of serious laparoscopic complications occur during umbilical entry
Umbilical access has a failure rate of 2.5–5%, while Palmer’s Point is reported as near 0% in patients without upper abdominal pathology
Anatomical risk (relevant in my case)
I have a low BMI (178 cm / 60 kg), meaning:
small bowel is often directly under the umbilicus
distance to major vessels is minimal
Palmer’s Point provides a greater safety margin, with bowel injury risk reported at <0.05%
Adhesions risk
Up to 15% of patients without prior surgery have adhesions behind the umbilicus
At Palmer’s Point this risk is <1%
Statistically, Palmer’s Point is the least likely entry site to encounter unseen adhesions
Infection, pain and healing
Umbilical ports show infection rates up to 8–10%, compared to <1% at other sites
The umbilicus is a skin fold, higher bacterial load, moisture, and friction (gross!)
Palmer’s Point is associated with:
lower infection rates
lower post-operative pain (lower nerve density)
Scar outcomes and structural changes
The claim that umbilical scars are “invisible” is contradicted by data:
25–30% of patients report visible changes (pigment changes, asymmetry, inversion)
The umbilicus is already scar tissue:
reduced blood supply
less predictable healing
Mechanical stretching and the often occurring ‘inversion’ (pulling the belly button inside out) during surgery can damage elastin fibers, leading to permanent deformation. (Women are often times not told this)
Nerve-related complications
The umbilicus is a nerve-dense region (T10–T11)
Up to 11% of patients report chronic abdominal wall pain after umbilical entry (nerve entrapment / neuropathy)
Total port-site morbidity (15–20%)
When combining “minor” complications:
Infection: up to 8–10%
Scar complications: 5–7%
Hernia / chronic pain: 3–5%
This results in approximately 1 in 5 patients (20%) not having an uncomplicated recovery at the umbilical site.
This contrasts with the near-zero complication rate reported for primary entry at Palmer’s Point.
Surgical access and visualization
Palmer’s Point provides better access to the entire abdominal cavity, including upper abdominal structures (e.g. diaphragm, liver)
Umbilical entry can limit access and may require additional ports
Core reasoning
The umbilicus is:
a pre-existing scar
more infection-prone
more nerve-dense
more likely to contain adhesions
Palmer’s Point:
uses healthy tissue
has a lower complication profile
provides a larger safety margin
Final position
I am explicitly refusing umbilical entry because:
it introduces avoidable risk
it carries a real risk of structural and sensory changes
and there is a clinically supported alternative (Palmer’s Point) with a better safety profile
This is not about preference or aesthetics. This is about risk reduction and long-term outcomes.
(UPDATE: I forgot to mention that there is a medical contradiction! Doctors are always quite hesitant to cut into scar tissue. (It has low blood flow, it’s not stretchy etc!) so their choice to choose the navel/bellybutton is strange. I haven’t been able to find a proper answer to this as well. The only thing that seems obvious to me: the umbilical port is easier for the doctor. It’s not standard for our well being.)
At the same time, body image and physical changes do matter. Even something that may be considered “minor” from a surgical perspective can have a real impact on how someone feels in their body. Your feelings are VALID.
There are women who struggle with this afterwards but don’t speak up, sometimes because they feel like they “should be grateful” that the surgery was technically successful. That doesn’t mean their experience isn’t real.
There is also some discussion in literature about how these changes can have a stronger psychological impact on people with sensory sensitivities (such as autistic or ADHD individuals), especially when the body’s structure feels or looks different afterwards.
Anyway, that’s my little autistic rant😭✋🏻 This is a SUMMARY I have name this clear. This is not ALL the information out there, there is MORE.
others sites I visited fort research, this isn’t all but I forgot to write everything down…(oops)
[1] https://www.intechopen.com
[2] https://www.researchgate.net
[3] https://nl.surgaid-med.com
[4] https://nl.weidemedical-es.com