Body piercing affecting laparoscopy: perioperative precautions.

Piercing is an increasingly popular fashion trend mainly among adolescents. Umbilical piercing in particular can cause perioperative problems during laparoscopic procedures. We describe how to deal with this fashion trend in our institutions. First, any piercing needs to be documented during preoperative physical examination. During preoperative informed consent, patients are told that all pierced jewelry needs to be removed, preferably by the patient before the procedure. For the operation, patients may be offered the use of sterile "sleepers," which are substitutes made of plastic to avoid closure of the wound canal perioperatively. Postoperatively, most pierced jewelry can be put back into position after anesthesia has completely worn off. Only jewelry for piercings close to wounds (e. g., navel piercings) should not be reinserted until the skin is closed. Careful observation and increased hygienic effort to prevent local infection is necessary. To date, we have not seen any severe umbilical infection after laparoscopy. However, in several patients the umbilical pierced jewelry was back in the navel on the same day of surgery, sometimes immediately after waking from anesthesia. Hospital staff should know how to remove and substitute piercing jewelry as well as how to optimize hygienic care perioperatively to prevent umbilical wound infections. Time and effort for patient teaching and hygienic care are slightly increased.