abdominal incision.pptx
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This document discusses different types of abdominal incisions used in surgery. It notes that the ideal incision achieves accessibility, extensibility, and security. Common reasons for abdominal surgery include removing diseased tissue, repairing injuries, creating artificial openings, and inspection. General anesthesia, local anesthesia, spinal anesthesia, and regional anesthesia are types of anesthesia used. Vertical, transverse, and oblique incisions are classifications of abdominal incisions. Specific incisions described include the midline, paramedian, Kocher's subcostal, McBurney grid iron, Pfannenstiel, and Maylard transverse muscle cutting incisions.
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The document discusses various types of surgical incisions including their purposes, advantages, and disadvantages. It describes abdominal and pelvic incisions such as midline, paramedian, transverse, oblique, Kochler subcostal, McBurney, Pfannenstiel, and Maylard incisions. Langer's lines, which correspond to the natural orientation of collagen fibers, are also mentioned as incisions made parallel to these lines may result in better healing and less scarring. Key layers of the abdominal wall including skin, fascia, muscles and peritoneum are also defined.
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- 2. Abdominal Incision • 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. In doing so, three essentials should be achieved (Zinner et al, 1997): 1. Accessibility 2. Extensibility 3. Security
- 3. Reasons for Surgery • To remove diseased tissue (use suffix-ectomy) eg: gatrectomy • For Purposes of repair (use suffix- orraphy or plasty) eg: herniorraphy or arthroplasty • To produce an artificial opening ( use suffix-otomy or ostomy) eg: Gastrotomy, tracheostomy • For inspection (use suffix – oscopy) • Cystoscopy – inspection of bladder • Gastroscopy- inspection of stomach • Sigmoidoscopy- inspection of sigmoid
- 4. Types of Anaesthesia • General- Inhalation or IV • Local- • Spinal – injection into suarachnoid space surrounding cauda equina • Regional – by nerve plexus
- 5. Classification of incisions : • The incisions used for exploring the abdominal A) Vertical incision : These may be (i) Midline incision (ii) Paramedian incisions • (B) Transverse and oblique incisions : (i) Kocher's subcostal Incision (ii) Transverse Muscle dividing incision
- 6. (iii) Mc Burney’s Grid iron or muscle spliting incision (iv) Oblique Muscle cutting incision (v) Pfannenstiel incision (vi) Maylard Transverse Muscle cutting Incision (C) Abdominothoracic incisions
- 8. Kocher's subcostal Incision • The subcostal incision is started at the midline, 2 to 5 cm below the xiphoid and extends downwards, outwards and parallel to and about 2.5 cm below the costal margin a) Chevron (Roof Top) Modification : The incision may be continued across the midline into a double Kocher incision or roof top approach (Chevron Incision) b) The Mercedes Benz Modification Variant of this incision consists of bilateral low Kocher’s incision with an upper midline limb up to and through the xiphisternum
- 10. McBurney Grid iron • Classically, the McBurney incision is made at the junction of the middle third and outer thirds of a line running from the umbilicus to the anterior superior iliac spine, the McBurney point