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A vertical cut, or incision, is made in the middle of the abdomen. This midline incision extends from the xiphoid process at the bottom of the chest to the pubic symphysis at the bottom of the pelvis. The fibrous tissue of the linea alba, which separates the right and the left abdominal muscles, serves as a guide for
The most common incision for laparotomy is a vertical incision in the middle of the abdomen which follows the linea alba. [citation needed] The upper midline incision usually extends from the xiphoid process to the umbilicus. A typical lower midline incision is limited by the umbilicus superiorly and by the pubic symphysis inferiorly.
A midline incision may be preferred as well when the fetus lies transversely across the patient's uterus or if the placenta lies in the area where the low transverse incision is made. In practice, however, the midline incision is rarely used. [3] Other hysterotomy incisions include a high transverse incision and a fundal incision. [2]
Continuous monofilament suture closure of lateral edges of the rectus muscle to the anterior rectus fascia prevents hernia. Patients should wear a binder for at least 2 weeks. No incision provides wider pelvic exposure, and is relatively painless compared to midline incisions. Result is the most pleasing cosmetic result of any abdominal incision.
The linea alba (Latin for: white line) is a strong fibrous midline structure [1] of the anterior abdominal wall [2] situated between the two recti abdominis muscles (one on either side). The umbilicus (navel) is a defect in the linea alba through which foetal umbilical vessels pass before birth. [ 1 ]
Access is accomplished by laparotomy, historically by a bilateral subcostal ("chevron") incision, possibly with midline extension (Calne or "Mercedes-Benz" incision). Nowadays a broadly used approach for open liver resections is the J incision, consisting in a right subcostal incision with midline extension. [ 4 ]
The modified Gibson incision allows proper access to the small bowel and pelvic organs and limited access to omentum. It is also possible to have tactile assessment of large bowel and subdiaphragmatic surfaces using this incision. This incision is preferred for lymph node dissection, as extra peritoneal approach of pelvic sidewall is possible.
The abdomen is inflated with carbon dioxide gas to facilitate visualization and, often, a small video camera is used to show the procedure on a monitor in the operating room. The surgeon manipulates instruments within the abdominal cavity to perform procedures such as cholecystectomy (gallbladder removal), the most common laparoscopic procedure ...