Term
| list 9 types of incisions |
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Definition
Rt. Upper paramedian
Lt. lower paramedian
C. Rt. subcostal
D. Rt. midline transverse
E. Pfannenstiel
F Upper longitudinal midline
G. Lower longitudinal midline
H. McBurney’s
I. Rt. inguinal oblique |
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Term
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Definition
Oblique incisions
Subcostal
McBurney
Lower oblique |
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Term
| name 3 transverse incisions |
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Definition
Transverse
Pfanenstiel
Midline transverse
Thorocoabominal |
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Term
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Definition
Simplest abdominal incision to perform
Excellent primary incision
Good exposure to any part of the abdomen cavity
Hemostasis is easily achieved
Incision can be extended from just below the sternal notch, around the unbilicus, back to the midline and down to the symphysis pubis
Postoperative hernias are more common above the unbilicus than below
Midline crossover vasculature is permanently altered |
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Term
| paramedian (rectus) incision |
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Definition
Vertical incision placed approximately 2 inches lateral to the midline on either side of the upper or lower abdomen
Used infrequently because it adds little to the exposure to that of the midline vertical incision
Take longer to create, close are more prone to herniation, especially when they are more lateral |
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Term
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Definition
Muscle splitting incison
Used most commonly for appendectomy
When muscles are divided in line with their direction of pull there is less chance of postoperative herniation or disruption |
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Term
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Definition
Lower Oblique Inguinal
Oblique right or left inguinal incision extends from the tubercle to the anterior iliac crest, slightly above and parallel to the inguinal crease
Standard incision for for open inguinal herniorrhaphy
Does not typically interrupt major abdominal arteries
Long, lower abdominal oblique incisions may be used for transplant, urologic and vascular procedures
These may result in ligation of the deep inferior epigastric artery |
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Term
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Definition
Subcostal Incision (Kocher )
Right side for open procedures of gallbladder, biliary system and pancreas
Left side for surgery on the spleen
Provides limited exposure unless the patient is short with a wide abdomen and wide costal margins
Good cosmetic result
Follows skin lines
Nerve damage is minimal
Painful incision postoperatively |
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Term
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Definition
Pfannenstiel
Used for pelvic surgery
Curved transverse incision across the lower abdomen
Approximately ½ inch above the symphysis pubis, usually within the pubic hairline
Standard incision for open obsterical and gynecologic procedures
Does not alter the vascular supply to the abdominal wall if the deep inferior epigastric artery is left intact
Provides good exposure, cosmetic acceptable scar |
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Term
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Definition
Used on right or left for a retroperitoneal approach
Slightly above or below the umbilicus or either side carried laterally to the lumbar region at an angle between the ribs and the iliac crest
Runs parallel to vessels and nerves, rarely causes permanent damage
Standard incision for transverse colectomy or colostomy and choledochojejunostomy |
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Term
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Definition
Standard incision for surgery of proximal stomach, distal esophagus and anterior spine
Patient in lateral position
Incision begins at midpoint between the xyphoid and umbilicus and extends posteriorly across the seventh or eighth interspace and the midscapular line into the chest
Superior epigastric artery is sacrificed |
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Term
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Definition
Most of the liver
Gallbladder
Duodenum
Head of pancreas
Hepatic flexure of the colon
Part of ascending and transverse colon |
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Term
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Definition
Left lobe of the liver
Stomach
Spleen
Body and tail of pancreas
Splenic flexure of the colon
Part of the transverse and descending colon |
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Term
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Definition
Cecum
Appendix
Right ureter
Right ovary and fallopian tube
Right spermatic cord |
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Term
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Definition
Part of descending colon
Sigmoid colon
Left ureter
Left ovary and fallopian tube
Left spermatic cord |
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