4. Depend upon
Type of surgery [elective/emergency]
Target organ
Surgeons own experience and preference and
Previous surgery.
5.
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.
12.
13.
14. Rooftop incision used for gastrectomy,
oesophagectomy, pancreatectomy, hepatic
resection, and liver transplantation.
Mercedes banz modification classically used
for liver transplantation.
15.
16.
17.
18.
19.
20. It is a variation of mcburneys incision that is
made the same point but in transverse plane.
It gives cosmetically good scar.