II nerve enters canal from the side (pierces internal oblique), leaves through superficial ring, supplies skin over inguinal region, upper part of thigh, root of penis, anterior third of scrotum
Midline- linea alba, bloodless plane, good for rapid access. ?weak since less vascular Paramedian 1 inch from midline. Rectus sheath opened, rectus displaced laterally, posterios sheath and peritoneum incised. On closing, peritoneal sutures covered by rectus muscle, strengthens peritoneal scar.It can be extended upwards into 8 th /9 th incostal space (thoracoabdominal incision), thereby extensive access to upper abdomen & thorax Transrectus-same as paramedian but rectus not reflected, instead cut. Laterally-derived blood and nerve supply disrupted. Kochers- R side biliary surgery, L side spleen. 8 th intercostal nerve sacrificed, 9 th preserved Transverse muscle-split incision (starts 1inch above ASIS) preferred generally, in line with skin creases, adequate access with muscles split not cut Pfallenstiel- used for pelvic access
Mobility and Stability required for propelling large volumes of food, fluid, gas Alternate segments lost their mesentery and became secured for stability, thereby secondary retro peritoneal, therefore lying directly on top of primary retroperitoneal structures. Other sections are mobile to distend and alter their relative position (mobility).
Serous membrane- single layer flat cells, secrete fluid to minimise friction
Abdo cavity consists of abdo viscera (with peritoneum) and peritoneal cavity Both of utmost importance to surgeon, the cavity to plan safe planes of dissection. Entire GI tract develops on dorsal mesentery. Foregut also has a ventral mesentery, attaching it to anterior abdo wall
Abdo cavity consists of abdo viscera (with peritoneum) and peritoneal cavity Both of utmost importance to surgeon, the cavity to plan safe planes of dissection. Entire GI tract develops on dorsal mesentery. Foregut also has a ventral mesentery, attaching it to anterior abdo wall