An Overview on Umbilical Laparoscopic Entry and Lee–Huang Laparoscopic Entry

Abstract

Background: Laparoscopic entry is a critical step in minimally invasive surgery, as improper access may result in serious complications, including vascular injury, bowel perforation, and failed abdominal entry. Umbilical entry remains the conventional approach because of its anatomical accessibility, relatively thin abdominal wall, and favorable cosmetic outcomes. However, its safety may be compromised in patients with previous abdominal surgery, periumbilical adhesions, obesity, or large pelvic masses. The Lee–Huang point, located midway between the xiphoid process and the umbilicus, has been proposed as an alternative entry site that may reduce the risk of encountering periumbilical adhesions while providing improved visualization of the abdominal cavity. Both approaches have distinct anatomical advantages, technical considerations, and potential complications. Nevertheless, direct comparative evidence remains limited, and no single entry technique is universally appropriate for all patients. This review aims to compare umbilical and Lee–Huang laparoscopic entry regarding their anatomical rationale, surgical techniques, safety profiles, clinical indications, and potential complications. It also highlights the importance of individualized patient selection, careful preoperative assessment, and appropriate surgical expertise in minimizing entry-related complications and improving operative outcomes.