What are the different types of abdominal incisions?
This article discusses the anatomy of the abdominal wall, anatomy of the rectus sheath and common abdominal surgical incision types (midline, paramedian, pararectal, Gridiron, Lanz, Pfannenstiel, transverse, Kocher).
What surgery uses midline incision?
The midline incision (no. ①) is used for a wide array of abdominal surgery, as it allows the majority of the abdominal viscera to be accessed. A midline laparotomy can run anywhere from the xiphoid process to the pubic symphysis, passing around the umbilicus.
What is a midline abdominal incision?
Midline incision: incision that follows the linea alba (a relatively avascular structure) to access most of the abdominal viscera; performed on a wide variety of abdominal surgeries, including emergency procedures, as this incision causes minimal blood loss; the downside is the susceptibility of significant scars.
What is a McBurney's incision used for?
When the diagnosis of appendicitis is clear, the McBurney incision is one of two incisions used for appendectomy. The McBurney's Point is located one third of the distance from the anterior superior iliac crest to the umbilicus. This is the classic location of the appendix.
How long does it take for a midline incision to heal?
Long-term outlook Recuperation time following laparotomy is usually six weeks, but may vary depending on whether other procedures are performed at the same time. As with any post-operative recovery, it is important to always consult your doctor. Make sure you have a final check-up.
What surgery has the longest recovery time?
These procedures below do take the longest to recover.Liposuction (up to three months) ... Tummy Tuck (2-3 months) ... Facelift (two months) ... Breast Reduction (two months) ... Breast Augmentation (six weeks) ... Rhinoplasty (six weeks)
What are the different types of incisions?
Issues of ConcernMidline Incisions. Also known as the laparotomy incision, or celiotomy, this is the most traditional of surgical incisions. ... Kocher Incisions (Subcostal) ... Para-median Incision. ... Gridiron Incision (McBurney Incision) ... Lanz (Rockey-Davis) ... Thoracoabdominal (Iver Lewis) ... Chevron. ... Pfannenstiel (Kerr/Pubic incision)More items...•
Which abdominal incision is better for healing?
Incision through the umbilicus has no negative effect on wound healing. The upper abdominal incision gives good access to the viscera in the upper abdomen and this incision can be combined with a thoracotomy for oesophageal surgery. Lower abdominal incisions can also be midline, paramedian or pfannenstiel incisions.
What is thoracoabdominal incision?
The thoracoabdominal incision was first described in 1946 as an approach to concomitant abdominal, retroperitoneal, and thoracic injuries. In urology, this technique was popularized in 1949 for the resection of large renal tumours.
Where is McBurney's point on abdomen?
0:060:47How to find McBurney's Point - YouTubeYouTubeStart of suggested clipEnd of suggested clipSo we're the umbilicus. Next year we're going to find the anterior superior iliac spine the ASIS.MoreSo we're the umbilicus. Next year we're going to find the anterior superior iliac spine the ASIS. And what you'll be doing is you'll be palpating with your whole hand feeling for the rigid. Point
How do I check my McBurney's point?
McBurney point corresponds to the location of the base of the appendix and is found by placing the little finger of one hand in the umbilicus and the thumb on the anterior superior ileal spine.
Where is the McBurney's point?
McBurney's point is the name given to the point over the right lower quadrant of the human abdomen that is one-third of the distance from the anterior superior iliac spine (ASIS) to the umbilicus 1).
What incision is used for appendectomy?
Open appendectomy. A cut or incision about 2 to 4 inches long is made in the lower right-hand side of your belly or abdomen. The appendix is taken out through the incision.
What is the incision routinely used for open cholecystectomy?
Incision. A right subcostal (Kocher) incision is the most often used incision and allows excellent exposure of the gallbladder bed and cystic duct. Alternatively, an upper midline incision can be used when other concomitant operations are planned and a wider exposure is needed.
Where is the incision for stomach surgery?
Generally, upper abdominal incision can be midline through the lineal alba or paramedian. The paramedian incision can be mucle- retracting or muscle-splitting (1), (8). If necessary, the midline incision may be extended through the umbilicus or by the side of umbilicus.
Which incision is used most commonly for emergency surgery?
An abdominal incision is a cut made through your skin on the belly to expose the abdominal organs or to facilitate an operation or a procedure. Incisions or cuts on your belly are mostly made during an emergency or a planned surgery.
What is the Pfannenstiel incision?
Pfannenstiel incision. The Pfannenstiel incision is a firm favourite of obstetricians for accessing the gravid uterus for which a curvilinear incision is made through the skin and subcutaneous fat, then a longitudinal incision made in the linea alba.
What is a gridiron incision?
A gridiron incision involves an arcing incision through the skin, subcutaneous fat and fascia, external and internal obliques, transversus abdominis and transversalis fascia. It is commonly used for open appendicectomies. The incision is centred over McBurney’s point two-thirds of the distance between the umbilicus and the right anterior superior iliac spine (ASIS), where the base of the appendix is most likely to be found. This classically corresponds to the area of maximal tenderness on clinical examination when the appendix has become sufficiently inflamed to cause localised peritonitis. This incision may be modified to follow the horizontal Langer’s lines for improved cosmesis. Disadvantages include the risk of injury to the ilioinguinal and iliohypogastric nerves. The arc may be extended cephalad and laterally in order to facilitate access to the ascending colon, which is known as the Rutherford-Morison incision.
What are the lateral abdominal walls?
The lateral abdominal walls are formed by a triad of muscles: the external oblique (E.O), with its fibres running inferomedially like the fingers of the hands placed into the front pockets of one’s jeans; the internal oblique (I.O) with its fibres running orthogonally to its external relation, and transversus abdominis (T.A) with its horizontal fibres. Superficial to the external oblique lies Scarpa’s membranous fascia, Camper’s subcutaneous fatty layer, and the skin. Deep to transversus abdominis, the transversalis fascia encircles the preperitoneal fat and parietal peritoneum.
What is the abdominal cavity?
The abdominal cavity is an ovoid space bounded cephalad by the diaphragm and inferior thoracic margin, caudally by the pelvic brim, posteriorly by the lumbar spine along with quadratus lumborum, psoas major and iliacus, and anterolaterally by the retaining musculature of the abdominal wall.
What is the white line between the recti?
The aponeurotic components of the sheath interdigitate in a thickened fibrous midline raphe between the two recti known helpfully as the linea alba (‘white line’). An elastic defect in this raphe may allow the fascia to stretch and abdominal contents to bulge forward through the resulting divarication of the recti.
Which ligament is commonly encountered when the incision is made to the right of the midline?
The falciform ligament of the liver is commonly encountered if the incision is made to the right of the midline, and the tendinous intersections must be divided on the chosen side in order to access the peritoneum. Paramedian abdominal incision.
Is the Lanz incision more subtle than the gridiron?
The Lanz incision was designed to be more cosmetically subtle than the gridiron, with the benefit that it may be hidden beneath the bikini line but the disadvantage of commonly severing the ilioinguinal and iliohypogastric nerves.
Principles of Surgical Incisions
The specific surgical incision will depend on the underlying pathology, site, patient factors, and the surgeon’s preference and experience.
Lanz Incision and Gridiron Incision
The Lanz and Gridiron incisions are two incisions that can be used to access the appendix, predominantly for appendicetomy.
Midline Incision
The midline incision (no. ①) is used for a wide array of abdominal surgery, as it allows the majority of the abdominal viscera to be accessed.
Paramedian Incision
The paramedian incision (no. ②) is rarely performed in the UK. It was originally used to access much of the lateral viscera, such as the kidneys, the spleen, and the adrenal glands.
Kocher Incision
A Kocher incision (no. ③) is a subcostal incision used to gain access for the gall bladder the biliary tree.
Laparoscopic Port Sites
Laparoscopic surgery (keyhole surgery) requires small incisions to be made in the skin, which allow instruments to be passed into the abdominal cavity. Common instruments include the camera, cutting and dissecting scissors, and grippers.
Where is the paramedian incision?
Paramedian incisions: These incisions are made 2-5 cm beside the midline of the trunk on your abdomen (belly). It provides access to tummy structures such as the stomach, liver, and spleen. It avoids any injury to the nerves, limits trauma to your rectus (belly muscle), and permits good restoration of functions afterward.
What is an abdominal incision?
Center. An abdominal incision is a cut made through your skin on the belly to expose the abdominal organs or to facilitate an operation or a procedure. Incisions or cuts on your belly are mostly made during an emergency or a planned surgery. Although laparoscopic surgery has reduced the need for large incisions, ...
What are the complications of incisions?
Bursting open of a wound. Fistula (hole formation) Wound pain. Hernia (bulging of the organ through belly openings) Scarring. The complications of incisions nowadays have been reduced because many surgeons are now opting for mini-incisions as small as a keyhole (laparoscopic surgery).
Why do surgeons use transverse incisions?
Moreover, it is used in surgeries performed on people who are overweight and have short stature. Transverse incisions reduce the risk of dehiscence ( wound bursting open). However, the risk of protrusion of the organs through the abdominal wall is higher with these incisions.
Where are midline incisions made?
Midline incisions or median incisions: These incisions are made on the midline of your abdomen (belly). It is mostly favored in open surgery for diagnostic purposes (laparotomy) because it allows wide access to all areas of your abdomen and organs.
What is Maynard's incision?
Maynard's incisions: These are true muscle-cutting incisions. They give excellent exposure to the genital organs. They are made parallel to the traditional placement of Pfannenstiel's incisions. They are also as popular as Pfannenstiel’s incisions for cesarean delivery and are used for cancer surgeries.
How long are bikini incisions?
They are also known as bikini incisions. They are made just 5 cm above your groin area (pubic) and are mostly 12 cm long.
