Abdominal incisions Flashcards
How often is a midline incision performed?
Commonest approach to the abdomen
What structures are divided in a midline incision?
Structures divided: linea alba, transversalis fascia, extraperitoneal fat, peritoneum (avoid falciform ligament above the umbilicus)
What can be accessed via a midline incision?
Bladder can be accessed via an extraperitoneal approach through the space of Retzius
Where is the paramedian incision?
Parallel to the midline (about 3-4cm)
What structures are divided/retracted in a paramedian incision?
Structures divided/retracted: anterior rectus sheath, rectus (retracted), posterior rectus sheath, transversalis fascia, extraperitoneal fat, peritoneum
How is a paramedian incision closed?
In layers
Where is a battle incision?
Similar location to paramedian but rectus displaced medially (and thus denervated)
How often is a battle incision used?
Seldom used
Where is Kocher’s incision?
Incision under right subcostal margin e.g. Cholecystectomy (open)
Where is Lanz incision?
Incision in right iliac fossa e.g. Appendicectomy
What is a Gridiron incision?
Oblique incision centered over McBurneys point- usually appendicectomy (less cosmetically acceptable than Lanz)
What is a Gable incision?
Rooftop incision
What is Pfannenstiel’s incision?
Transverse supra pubic, primarily used to access pelvic organs
What is McEvedy’s incision?
Groin incision e.g. Emergency repair strangulated femoral hernia
What is a Rutherford Morrison incision?
Extraperitoneal approach to left or right lower quadrants. Gives excellent access to iliac vessels and is the approach of choice for first time renal transplantation.
