Examination of abdominal scars











Midline laparotomy




Position: vertical incision through the linea alba.



Use: most widely used incision for exploring the abdominal cavity.




Xiphisternum to pubis incisions are used for major operations, giving access to all peritoneal, retroperitoneal and pelvic organs.




e.g. trauma laparotomies, open abdominal aortic aneurysm repairs and total colectomies.



Upper midline laparotomies (xiphisternum to umbilicus) are used for accessing the upper digestive tract, spleen and gallbladder e.g. perforated gastric ulcer.



Lower midline laparotomies (umbilicus to pubis) are used for accessing the lower digestive tract.




e.g. sigmoid colectomy.



Paramedian incision




Position: vertical incision through the anterior rectus sheath with lateral retraction or splitting of the rectus abdominis muscle.



Use: rarely used nowadays; for access to the duodenum, stomach, spleen or kidneys.



Battle’s incision




Position: lower pararectus incision with medial retraction of the rectus muscle.



Use: less commonly used for open appendicectomy; open insertion of CAPD (continuous ambulatory peritoneal dialysis) catheter.



Kocher’s incision




Position: oblique subcostal incision in right or left upper quadrant. Transects the rectus abdominis and transversus abdominis muscles.



Use: access to the gallbladder (right side, e.g. open cholecystectomy) or spleen (left side).



Rooftop/chevron incision




Position: bilateral oblique subcostal incisions that are joined subxiphisternally (bilateral Kocher’s incisions).

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Feb 18, 2017 | Posted by in GENERAL SURGERY | Comments Off on Examination of abdominal scars

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