Abdominal Incisions in General Surgery: A Review

ABSTRACT

There is this wrong notion that the only standard abdominal incision is the midline incision. Cases have been seen in which an abdominal incision extends from the xyphoid process to the symphysis pubis just to remove a perforated appendix! It is also not unusual to see a groin incision together with a lower abdominal incision for an obstructed inguinal hernia repair that “slipped” back into the abdominal cavity during preparation for surgery. Even though the trend nowadays in surgery is to opt for laparoscopic and mini-incision surgery, the basic rule in surgery is to have an incision that will be comfortable for the surgeon and provide adequate access to the area of pathology.

Introduction

What prompted this review article is because of the wrong notion that the only standard abdominal incision is the midline incision. Cases have been seen in which an abdominal incision extends from the xyphoid process to the symphysis pubis just to remove a perforated appendix! The reason proffer for this was

“……we thought the patient had a perforated duodenal ulcer, so we made an upper midline incision. On exploring the abdomen we found out that it was a perforated pelvic appendix, so we extended our upper midline incision downwards to have adequate access to remove the appendix”!

It is also not unusual to see a groin incision together with a lower abdominal incision for an obstructed inguinal hernia that “slipped back” into the abdominal cavity during preparation for repair.

One of the most underrated aspects of surgical procedure is the placement of skin incisions. The purpose of this paper is to identify various types of abdominal incisions that make certain surgical procedure a bit easier, and to avoid unnecessary long abdominal incisions.

Read more