An incision is a cut made by a surgeon during surgery. This document describes and compares various types of abdominal incisions including their advantages and disadvantages. Midline incisions provide good access but are cosmetically disapproved. Para-median incisions have weaker muscle repair but access lateral structures. Transverse incisions have the best cosmetic results but take more time. McBurney incisions are best for appendicectomies while Pfannenstiel incisions are commonly used in gynecological and obstetric surgeries.

1. Misbah Azher
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2.  An incision is a fine cut made by a surgeon during
surgery.
 Abdominal incision -> Incision on abdominal wall

4. 1.Midline Incisions-A vertical incision which follows the
linea alba.
 It may be:
- upper midline incision
-lower midline incision
-single incision

5.  Advantages-
-almost bloodless
-no muscle fibers are divided
-no nerves are injured
-good access to upper abdominal viscera
-very quick to make as well as to close
-can be extended full lenght of abdomen curving around umblical scar
 Disadvantages-
-Cosmetically not approved
 Used in surgeries like Like in perforated appendix, twisted ovarian
cyst, ileal perforation.

6. 2. Para median Incision- It is made 2 to 5 cm lateral to
umbilicus.

7.  Advantages-
-vertical incision to right or left,provides access to lateral str. such as
spleen or kidney.
-closure is theoretically more secure because rectus muscle can act as
a buttress between reapproximated posterior and anterior fascial
planes
 Disadvantages-
- It tends to weaken and strip off the muscles from its lateral vascular
and nerve supply resulting in atrophy of the muscle medial to the
incision.
-The incision is laborious and difficult to extend superiorly as is
limited by costal margins.
-It doesn’t give good access to contralateral structures.
- Comparatively more bleeding

8.  Advantages:
- best cosmetic results
- less painful
-faster healing postoperative
- greater strength
 Disadvantages:
-more time-consuming
-more haemorrhagic
- compromised ability to explore upper abdominal cavity
- division of multiple layers of fascia and muscle and nerves,
may result with haematoma or seroma in potential spaces.

9. Is started at midline ,2 to 5 cm below the xiphoid,and
extends downwards outwards and parallel to and
about 2.5 cm below costal margin
-It affords excellent exposure to gall bladder and biliary
tract and can be made on left side to afford access
to spleen.
-Especially used in cholecystectomy

10.  is divided into :
-Chevron (Roof Top) Modification-
Rooftop incision used for gastrectomy,
oesophagectomy, pancreatectomy,
hepatic resection, and liver
transplantation.
-The Mercedes Benz Modification-
bilateral Kochlar incision with
extension upto xphisternum
,classically used for liver
transplantation , diaphragmatic
hiatuses.

11.  In newborn and infants, this incision is preferred bcs
more abdominal exposure is gained per lenght of incision
than with vertical exposure
 Because infants’ abdomen longer transverse than vertical
girth.
 Also true of short, obese adult

12.  Incision is made at the McBurney point.
 Originally placed the incision obliquely from above
laterally to below medially.
 Incision of choice most appendicectomies
 Similar incision can also used in left lower
quadrant to deal with certain lesion of sigmoid
colon such as drainage of diverticular abscess

13.  It is a variation of mcburneys incision that is made the
same point but in transverse plane.
 It gives cosmetically good scar.

14.  Eponym of Rutherford-Morrison Incision
 Extension of McBurney incision by division of oblique
fossa
 Can be used for right and left sided colonic
resection, caecostomy or sigmoid colostomy

15.  Used frequently by gynecologist and urologist for
access to pelvic organ, bladder, prostate and for c-
section.
 is usually 12 cm long and is made in skin fold
approximately 5 cm above symphysis pubis

16.  gives excellent exposure to pelvic organ
 Skin incision is placed above but parallel to
traditional placement of Pfannenstiel incision

17.  Either right or left
 Converts pleural and peritoneal cavities into one
common cavity
 Thereby gives excellent exposure
 Right incision may be particularly useful in elective
and emergency hepatic resections
 Left incision may be used in resection of lower end
of esophagus and proximal portion of stomach.
 Incision is extended along line of 8th intercostal
space,the space immediately distal to inferior pole of
scapula.

20. 1. Kochlar
2. Median
3. Mc-Burney
4. Battle
5. Lanz
6. Para-Median
7. Transverse Muscle Cutting
8. Oblique Muscle Cutting
9. Pfannenstiel