Incisions for open abdominal surgery
- Jason S Mizell, MD, FACS
Jason S Mizell, MD, FACS
- Associate Professor of Surgery
- University of Arkansas for Medical Sciences
The success of any open surgical procedure requires, in part, a wisely chosen incision based upon sound anatomic principles.
Incisions for open abdominal surgery will be reviewed here. Closure of the abdominal wall and complications of abdominal wall incisions are discussed separately. (See "Principles of abdominal wall closure" and "Complications of abdominal surgical incisions".)
Choice of incision — The most important goal when choosing an abdominal incision is to provide adequate exposure for the anticipated procedure while taking into account the possibility that the planned procedure may change depending upon intraoperative findings or complications. The incision should interfere minimally with abdominal wall function by preserving important abdominal structures and heal with adequate strength to reduce the risk of wound disruption and subsequent incisional hernia. (See "Anatomy of the abdominal wall" and "Complications of abdominal surgical incisions".)
Additional considerations in selecting the type of incision include:
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- BASIC PRINCIPLES
- Choice of incision
- Skin incision
- Control of superficial bleeding
- Measures to control surgical site infection
- LONGITUDINAL INCISIONS
- Midline incision
- Paramedian incision
- Pararectus incision
- OBLIQUE INCISIONS
- McBurney's incision
- TRANSVERSE INCISIONS
- - Rockey-Davis or Elliot incision
- - Lumbotomy
- Incisions for pelvic operations
- - Pfannenstiel's incision
- - Cherney's incision
- - Maylard's incision
- - Küstner's incision
- - Turner-Warwick's incision
- REENTRY INCISIONS
- SPECIAL CONSIDERATIONS FOR OBESE PATIENTS
- SUMMARY AND RECOMMENDATIONS