Why do they go through the belly button for laparoscopic surgery?

September 21, 2025 •

3 min read

Over 2.5 million laparoscopic procedures are performed annually in the U.S., many involving the navel. The primary question, why do they go through the belly button for laparoscopic surgery?, is answered by several key medical and cosmetic benefits that have revolutionized modern surgery.

Quick Summary

Surgeons favor the belly button for laparoscopic surgery due to its unique anatomical properties, including its naturally thin and central entry point, which provides exceptional cosmetic results and faster patient recovery.

Key Points

Anatomical Advantage: The navel is a naturally weak point in the abdominal wall, allowing for easier and safer surgical entry with less muscle damage.
Minimally Invasive: Using the belly button helps reduce overall trauma, leading to less post-operative pain and a faster recovery.
Superior Aesthetics: Incisions are concealed within the natural crease of the navel, resulting in a nearly invisible scar.
Efficient Access: It provides a central and strategic entry point for instruments to reach different areas within the abdominal cavity.
Facilitates SILS: The navel is the primary access site for Single-Incision Laparoscopic Surgery (SILS), a highly advanced technique for minimizing scarring.
Reduced Complications: Smaller incisions at the umbilicus site contribute to a lower risk of post-operative complications like infections and hernias compared to open surgery.

The Anatomical Advantage of the Umbilicus

The most significant reason surgeons opt for the navel is its unique anatomy. The umbilicus, or belly button, is a natural scar left from the umbilical cord. This area consists of a fibrous band and has a much thinner abdominal wall fascia than other parts of the abdomen. This allows surgeons to access the abdominal cavity with less trauma and minimal disruption to the surrounding muscle and tissue layers. This direct, low-resistance entry point is ideal for inserting the initial trocar, the small tube through which the laparoscope and other instruments are passed. Utilizing this natural opening not only simplifies access but also reduces the risk of bleeding and damage to underlying structures.

Accessing the Abdominal Cavity Safely

Before inserting the instruments, surgeons perform a step known as creating the pneumoperitoneum. A needle is inserted through the small umbilical incision to insufflate the abdomen with carbon dioxide gas. This gas inflates the abdominal cavity, lifting the abdominal wall away from the internal organs. This process creates a spacious, safe working environment for the surgeon, allowing for better visualization and manipulation of instruments. The use of the central umbilical site as the initial port provides a wide, central view of the entire abdomen, orienting the surgeon and making subsequent port placements more precise.

Benefits of a Minimally Invasive Approach

Going through the belly button is a hallmark of minimally invasive surgery, offering several distinct advantages over traditional open procedures.

Reduced Pain: Smaller incisions mean less damage to nerves and muscles, leading to significantly less post-operative pain for the patient.
Faster Recovery: With less tissue trauma, patients experience a shorter hospital stay and can return to their normal activities much quicker than with open surgery.
Lower Risk of Complications: Smaller incisions reduce the risk of surgical site infections, hernias, and other wound-related complications.
Enhanced Cosmetic Results: The most aesthetically pleasing outcome is achieved by placing the incision in a natural body crease. The navel incision is often nearly invisible once healed.

Single-Incision Laparoscopic Surgery (SILS)

An even more advanced technique, Single-Incision Laparoscopic Surgery (SILS), takes the umbilical access method to the next level. In SILS, all surgical instruments and the laparoscope are inserted through a single, slightly larger incision hidden in the navel. This technique pushes the boundaries of minimally invasive procedures, resulting in an almost "scarless" outcome for the patient.

How Umbilical Access Compares to Other Sites

While the belly button is the standard initial access point, other port sites may be used depending on the specific procedure. Surgeons consider the location of the target organs, patient history, and potential complications when determining the best approach.


Feature	Umbilical Access	Other Port Sites	Traditional Open Surgery
Anatomical Entry	Thinnest fascia, avascular zone	Requires piercing muscle and fat layers	Large incision, extensive muscle cutting
Scar Concealment	Excellent, naturally hidden	Visible small scars	Large, visible scar
Pain Level	Low	Low to moderate	High
Recovery Time	Fast	Fast	Long
Surgical Visibility	Central, excellent for initial view	Specific to target area, can be limited	Excellent, direct view of organs
Post-Op Complications	Low risk of hernia/infection	Low risk of hernia/infection	Higher risk of hernia/infection

Considering Alternative Access Points and Risks

For some patients, the belly button may not be the ideal entry point. This can occur in cases of previous abdominal surgeries, where scar tissue might interfere with safe access, or when specific procedures require a different angle. In these instances, surgeons may opt for an incision in the upper or lower abdomen. Regardless of the entry site, proper surgical technique and patient education are key to a successful outcome.

Potential Complications: While rare, complications associated with umbilical access can occur. These include port site infection, umbilical hernia formation, or injury to internal organs. The likelihood of such events is significantly reduced by skilled surgical technique and careful patient selection.

Conclusion

The answer to why do they go through the belly button for laparoscopic surgery? is a confluence of anatomical convenience, patient benefit, and advanced surgical technique. It offers a naturally inconspicuous entry point that minimizes pain, reduces recovery time, and provides an excellent cosmetic outcome. For many procedures, the umbilicus represents the best pathway for surgeons to perform complex operations with precision and care, solidifying its place as a cornerstone of modern minimally invasive surgery. For more detailed information on specific procedures, you should always consult with your healthcare provider or visit authoritative resources like the Brigham and Women's Hospital website.

Frequently Asked Questions

Patients generally experience less pain than with traditional open surgery, as the incision is small and strategically placed to avoid major muscle groups. Post-operative pain is managed with medication.

No. While it is a common access point, surgeons may choose other incision sites based on the specific procedure, location of the target organs, and presence of prior scar tissue.

The resulting scar is typically very small and often hidden within the natural folds of the navel, making it minimally noticeable after healing.

For patients with an umbilical hernia, surgeons will assess the condition. They may choose to repair the hernia during the procedure or select a different access point to avoid complications.

The navel is an ideal entry point because it is a natural fusion point where the abdominal wall is thinnest, providing a direct and efficient pathway to the abdominal cavity.

A surgeon makes a small incision, and a port called a trocar is inserted. The laparoscope, a thin tube with a camera and light, is then passed through this port to provide a view of the internal organs.

Risks associated with umbilical access are rare but can include port site infection, hernia formation, or internal organ injury. Experienced surgeons take precautions to minimize these risks.

The surgeon inflates the abdomen with carbon dioxide gas, which elevates the abdominal wall. The laparoscope, with its camera and light, is then inserted through the belly button incision to provide a clear, magnified view on a monitor.