Table 2: Potential risk factors of abdominal metastasis.

(a) Patient
 (i) Local immunoreactions
 (ii) Wound hypoxia and acidosis leading to angiogenesis
 (iii) Hematogeneous spread around umbilicus
 (iv) Inflammation oncotaxis

(b) Disease
 (i) Advanced disease
 (ii) Adenocarcinoma cell type
 (iii) Peritoneal carcinomatosis
 (iv) Lymph node disease
 (v) Seed and soil theory

(c) Surgical technique
 (i) Mechanical port irrigation
 (ii) No use of endobags
 (iii) Trocar size
 (iv) Direct implantation by instruments or gloves

(d) Laparoscopic environment
 (i) Use of carbon-dioxide
 (ii) Pneumoperitoneum