This document discusses various types of surgical incisions including their criteria, advantages, and uses. It describes midline incisions which allow wide access to the abdominal cavity and are used for diagnostic laparotomies. It also covers paramedian incisions, which take longer but damage fewer vessels and nerves. Finally, it mentions specific incisions like right/left Kocher, rooftop, McBurney's, Pfannenstiel and their applications in procedures like gastrectomy, liver transplantation, hernia repairs and more.

1. Dated on;3rd may 2017

2.  Introduction
 Criteria for incision
 Choice of incision
 Classification
 Summary

4.  Depend upon
 Type of surgery [elective/emergency]
 Target organ
 Surgeons own experience and preference and
 Previous surgery.

6.  Midline incision; avertical incision which follows
the linea alba.
 It may be,
 upper midline incision;
 lower midline incision
 single incision.
SIGNIFICANCE;it is favoured
In diagnostic laporotmy,as it
Allow wide access to abdominal
Cavity.

7.  Like in perforated appendix,twisted ovarian
cyst, typhoid ileal perforation.

8.  It is made 2 to 5 cm lateral to umblicus.
 It has two advantages;
 it offers vertical incision to right or left
providing access to lateral structures like
spleen or kidney.
 Closure is theoretically more secure because
rectus muscle act as a buttress between
reapproximated posterior and anterior facial
planes.

9. midline paramedian
1. quick 1. Time consuming
2. rapid 2. laborous
3. vessels, nerves muscles not
damaged
3. Vessels nerves, mucsles damaged
4.Extensibility is limited. 4.Extensibility is limited bc of rib
cage
5. Blood less 5. More bleeding.

10.  Right and left kocher incision
 Rooftop/double kocher/chevron
 Gridiron/mcburney’s
 Lanz
 Rutherford morrison
 Battle’s
 Inguinal
 Pfannenstiel
 Mylard

11.  better cosmetically
 Stronger than vertical
 Less painful
 Good access to upper GI structures
 More advantageous in children b/c of more
transverse length of abdomen.

14.  Rooftop incision used for gastrectomy,
oesophagectomy, pancreatectomy, hepatic
resection, and liver transplantation.
 Mercedes banz modification classically used
for liver transplantation.

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

21.  Done for inguinal hernais, testicular cancer,
cryptochridism, hydrocele, varicocele.

25.  It commences 1.25cm below and lateral to renal
angle and passes downwad towards the
anterior superior iliac spine.