The McBurney incision has largely been supplanted by the Rockey-Davis incision, which is oriented transversely as opposed to obliquely, allowing for better. Rockey-Davis incision. Transverse skin incision in right lower quadrant with muscle splitting technique used in appendectomy. Cases have been seen in which an abdominal incision extends from the xyphoid process to the . Transverse or Davis-Rockey Incision (fig (fig10)10) ().
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For cosmetic reasons, skin incision nowadays for herniorrhaphy is usually a curvilineal incision along the skin crease.
This bucket-handle incision which is essentially a joined bilateral subcostal incision allows easy access to all these areas, and allows all these surgical procedures to be performed at the same time through this single incision. The intercostals muscles are divided with cautery and pleural cavity is opened and lung allowed to collapse. The skin incision is placed above but parallel to the traditional placement of Pfannenstiel incision.
Moreover, the quality of exposure provided by an incision influences the ease and safety with which an operation can be undertaken and the outcome in ways which defy easy quantification.
Therefore, transverse incisions parallel the direction of the fascial fibers and allow for ready reapproximation rockeg sutures placed perpendicular to these fibers. The major advantages of this incision are lesser postoperative pain, early recovery from the surgery and return to work and good cosmetic results Coelho et al, Abdomen and Rectum and Anus.
McBurney’s point-factor or fiction. Support Center Support Center. Avoiding muscle cutting while extending McBurney’s incision: McBurney originally placed the incision obliquely, from above laterally to below medially. Alternatively, when superior oncision of upper abdominal organs eg, the esophagogastric junction is required, thoracoabdominal incisions may be used.
Singapore Medical Journal, 41 1: British Journal of Urology, 46 6: British Journal of Obstetrics and Gynaecology; 91 1: Sugiura M, Futagawa S. It should be the aim of the surgeon to employ the type of incision considered to be the most suitable for that particular operation to be performed.
Surgical Incisions-Their anatomical basis.
ABDOMINAL INCISIONS IN GENERAL SURGERY: A REVIEW
gockey Those patients with an anterior appendix dafis usually easier to manage through a small incision, as opposed to retrocecal appendices which require an extended incision. Journal of Surgery Oncology, 56 3: Discussion The basic rule in surgery is to make an incision big enough and adequately placed to allow a comfortable access to the area of operation.
British Journal of Surgery, 74 8: Often, multiple incisions are possible for an operation. This incision was used until the mid primarily for the removal of the gall bladder, the spleen, and the left colon.
Acknowledgement I thank my daughter, Miss Olubunmi Olukemi Ajao for producing the illustrations in this paper. The incision is deepened to open the peritoneum Dorfman et al, Ventral hernia and other complications of 1, midline incisions.
Paramedian Incisions The skin incision is placed 2 to 5 cm lateral to the midline over the medial aspect of the bulging transverse convexity of the rectus muscle. This is the classic location of the appendix. Because the ddavis is limited this incision should be used only when surgery is planned on the pelvic organs Mendez et al, Alternatively, vertical incisions may be placed in a paramedian position, an approach that was previously more popular than it is today but continues to have its proponents.
The anterior rectus sheath is exposed and incised, and its medial edge is grasped and lifted up with haemostats. Conclusion Even though the trend in surgery nowadays is to opt for laparoscopic and mini-incisions, it is essential to be familiar with the location of various skin incisions that will provide easy and adequate access to the area of pathology. Use this site remotely Bookmark your favorite content Track your self-assessment progress and more!
The infraumbilical midline incision also divides the linea alba. Lancet, Mar 18; 1 British Journal of Surgery, Feb; 80 2: In general, re-entry into the abdominal cavity is best done through the previous laparotomy incision. Abstract There is this wrong notion that the only standard abdominal incision is the midline incision. Views Read Edit View history. This equivocal incision if placed lower can also be regarded as a right paramedian incision 1.
Vertical abdominal incisions – a choice?
Theodore Kocher originally described the subcostal incision; it affords excellent exposure to the gall bladder and biliary tract and can be made on the left side to afford access to the spleen Kocher, A randomized controlled trial”. Indeed, the adequacy of an incision is determined above all else by the safety with which orckey operation can be undertaken.
Back to Incision Index. Southern Medical Journal, 90 2: Journal of Urology, 99 5: