Part IV-Abdomen
the various incisions used in anterior abdominal wall their advantages &
disadvantages are discussed. An attempt has been made to add
Introduction :
1. Accessibility
2. Extensibility
3. Security
factors must be taken into consideration (a) preoperative diagnosis (b) the speed
with which the
1991).
Classification of incisions :
Modification)
spliting incision
Incision
A. Vertical incisions :
(1998).
(a) (b)
Young, 1992).
2001).
Surgical Incisions-Abdomen173
Disadvantages :
margin.
contralateral structures.
1997).
(Figure 7)
or herniation.
1994).
Surgical Incisions-Abdomen175
Kjossev, 1999).
1988).
sigmoid colostomy.
lower end.
(Figure 4)
Ti, 2000).
al, 1997).
References :
165(1): 235.
290-3.
Surgical Incisions-Abdomen177
10. Chute, R., Baron, J.A. Jr., Olsson, C.A. (1968): The
12. Clarke, J.M. (1989): Case for midline incisions. Lancet, Mar
17(4): 544-6.
14. Cox, P.J., Ausobsky, J.R., Ellis, H., Pollock, A.V. (1986):
79(12): 711-12.
27.
16. Denehy, T.R., Einstein, M., Gregori, C.A., Breen, J.L. (1998):
188-90.
32. Hendrix, S.L., Schimp, V., Martin, J., Singh, A., Kruger, M.,
451-2.
34. Kise, Y., Takayama T., Yamamoto, J., Shimada, K., Kosuge,
43. Miyazaki, K., Ito, H., Nakagawa, K., Shimizu, H., Yoshidome,
13(4): 283-9.
51(7): 429-36.
178-81.
74(7): 480-4.
57. Sato, H., Sugawara, Y., Yamasaki, S., Shimada, K.,
59. Talwar, S., Laddha, B.L., Jain, S., Prasad, P. (1997): Choice
78-9.
508-9.
Surgical Incisions-Abdomen
http://medind.nic.in/jae/t01/i2/jaet01i2p170.pdf
In surgical practice, deciding on the right type of surgical access for a specific condition would be a skill of its own for
a surgeon. The decision to select a specific incision would depend on the several elements. These would be,
Problem site Related anatomical structures Easy access Less complications Quicker healing Minimum scar
But, at instances, all these options might not be fulfilled and the surgeons have to make a professional judgment as to
decide on what's best for the patients' condition and act fast in order to save the life of the patient.
Out of many areas in the body, abdomen could be one area which sees many surgical incisions for different kinds of
surgical necessities. This article will discuss predominantly on abdominal incisions and its uses in surgical practice.
Also known as 'McBurneys incision', the incision is the most commonly used incision for 'appendicectomy'. The
incision will be placed at the McBurney's point which is at the junction between the middle one third and the outer one
third of a line extending from umbilicus towards the anterior superior iliac spine. It's commonly places obliquely and
2. Pfannansteil incision
The incision is the usual procedure adopted for surgical access towards pelvic organs and mainly for cesarean
sections. The incision is placed horizontally about 5 cm above the pubic symphysis and is about 12 cm in length.
The incision is placed below the costal margin or the lower margin of the rib cage and could be on either left or in the
right. But, most often the incision will be placed on the right side of the body to gain access to the gall bladder and the
billiary tree.
almost all abdominal organs and will facilitate good visualization as well. There are several advantages of this kind of
incision and being blood less plain is one of the most important. This incision is widely used in surgeries related to
bowel pathologies and especially in situations which require the necessity to remove part of the bowel.
Paramedian incisions are also used when the need arise to access certain organs towards a particular site.
Cheveron incision and Mercedes Benz Modifications are some of the other incisions which will allow the surgeons
Apart from these, it is vital to remember that a surgeon will be able to make a decision based on his clinical
experience on the placement of the incision as well as the required size of the incision. Therefore, the art of doing a
surgery would not be limited to text book patterns of incisions, but you can be assured that the above described
http://www.helium.com/items/1635785-common-types-of-surgical-incisions
List of Surgical Incisions
[edit]Agnew's incision
An incision used to release pus in the lacrimal sac in acute phlegmonous dacryocystitis. It is named after Cornelius Rea Agnew
[edit]Alexander incision
[edit]Auvray incision
[edit]Bar’s incision
[edit]Battle incision
a paramedian incision through the anterior and posterior rectus sheaths with medial retraction of the intact
rectus abdominis.
Associated persons:
William Henry Battle
Description:
Incision used in operation for appendicitis. Vertical incision of the abdominal wall with temporary
retraction of the rectus muscle medially.
Description:
Semi-circular incision of the skin just above the submammary fold for opening of mamma in severe
mastitis. The resulting scar is practically invisible.
[edit]Bergmann’s incision
[edit]Bevan’s incision
vertical incision parallel to outer border of rectus muscle; used for access to upper abdominal
quadrants.
[edit]Cherney incision
Suprapubic, transverse incision of rectus muscles off pubic bone; used to gain access to
reproductive organs in women. Technique originally described as using bilateral ligation of
inferior epigastric vessels to allow greater incision width; provides excellent access to Retzius
space and pelvic sidewall.
[edit]Chernez incision
[edit]Chevron incision
a bilateral subcostal incision in the abdomen, in the shape of an inverted “V”; used in upper abdominal
procedures. This is useful in carrying out total gastrectomy, operations for
renovascular hypertension, total oesophagectomy, liver transplantation, extensive
hepatic resections, and bilateral adrenalectomy etc
[edit]Circular incision
[edit]Clute incision
[edit]Deaver’s incision
an incision in the right lower abdominal quadrant, with medial displacement of the rectus muscle
[edit]Dührsen incision
[edit]Fergusson’s incision
An incision used in maxillectomy, along the junction of cheek and nose, to bisect the upper lip.
Resection of maxilla; uses incision running along border of nose and cheek and around ala to
midline and bisects upper lip.
[edit]Fowler’s incision
[edit]Girdiron's incision
An oblique incision made in the right lower quadrant of the abdomen, classically used for appendectomy
[edit]Graefe incision
(1) removal of cataract by a limbal incision with capsulotomy and iridectomy. Both operations were landmarks
in the field of ophthalmic surgery; (2) iridectomy for glaucoma.
Technique for removing cataract and lens by laceration of capsule and iridectomy; approach via
incision in sclera.
[edit]Heerman’s incision
[edit]Hartmann incision
resection of a diseased portion of the colon, with the proximal end of the colon brought out as a
colostomy and the distal stump or rectum being closed by suture.
[edit]Kerr incision
A low transverse incision in C-sections, preferred as there is less blood lost during surgery, less risk
of rupture in future pregnancies, less postoperative infections and it is easier to repair.
[edit]Kocher’s incision
An oblique incision made in the right upper quadrant of the abdomen, classially used for open cholecystectomy. Named after Emil
Theodor Kocher. It is ppropriate for certain operations on the liver, gallbladder and biliary tract.[1][2] This shares a name with the
Kocher incision used for thyroid surgery: a transverse, slightly curved incision about 2 cm above the sternoclavicular joints;
[edit]Kustner’s incision
Similar to Pfannenstiel incision; uses slightly transverse incision beginning just below anterior
iliac spine on each side and runs to just below pubic hairline. Fascia is incised through midline
(unlike transverse fascial incision in Pfannenstiel), rectus muscles are retracted laterally, and
peritoneum is opened in midline.
[edit]Langenbeck’s incision
[edit]LaRoque’s incision
[edit]Lynch’s incision
[edit]Mac Arthur's incision
[edit]Marylard incision
A variation of Pfannenstiel incision is the Maylard incision in which the rectus abdominis muscles are sectioned transversally to
[edit]McBurney incision
This is the incision used for open appendectomy, it begins 2 to 5 centimeters above the anterior superior iliac spine and continues to
a point one-third of the way to the umbilicus (McBurney's point). Thus, the incision is parallel to the external oblique muscle of the
abdomen which allows the muscle to be split in the direction of it's fibers, decreasing healing times and scar tissue formation. This
incision heals rapidly and generally has good cosmetic results, especially if a subcuticular suture is used to close the skin.[4]
[edit]Median sternotomy
This is the primary incision used for cardiac procedures. It extends from the sternal notch to the xiphoid process. The sternum is
divided, and a finochietto retractor used to keep the incision open. [5]
[edit]Midline incision
The most common incision for laparotomy is the midline incision, a vertical incision which follows the linea alba.
The upper midline incision usually extends from the xiphoid process to the umbilicus.
A typical lower midline incision is limited by the umbilicus superiorly and by the pubic symphysis inferiorly.
Sometimes a single incision extending from xiphoid process to pubic symphysis is employed, especially in trauma
surgery.
Midline incisions are particularly favoured in diagnostic laparotomy, as they allow wide access to most of the abdominal cavity.
[edit]Mackenrodt incision
A transverse, semilunar incision in the abdomen.
[edit]Parker's incision
[edit]Perthes' incision
Associated persons:
Georg Clemens Perthes
Description:
A surgical incision for exposure of organs in the right upper abdominal quadrant.
[edit]Péan's incision
[edit]Pfannanstiel’s incision
The Pfannenstiel incision, a transverse incision below the umbilicus and just above the pubic symphysis.[6][7] In the classic
Pfannenstiel incision, the skin and subcutaneous tissue are incised transversally, but the linea alba is opened vertically. It is the
incision of choice for Cesarean section and for abdominalhysterectomy for benign disease.
[edit]Rocky-Davis’ incision
The Davis or Rockey-Davis "muscle-splitting" right lower quadrant incision for appendectomy.
This incision bears the eponym of the Rutherford-Morrison incision. This is extension
of the McBurney incision by division of the oblique fossa and can be used for a right
or left sided colonic resection, caecostomy or sigmoid colostomy.
[edit]Schuchardt’s incision
A paravaginal rectal displacement incision, a surgical technique of making
the upper vagina accessible for fistula closureor radical surgery via the vagina.
[edit]Shambaugh incision
[edit]Yorke-Mason’s incision
[edit]Warren incision
Skin incision tracing thoracomammary fold.
[edit]Wilde's incision