Transverse abdominal incisions in pelvic surgery
1940; Elsevier BV; Volume: 39; Issue: 4 Linguagem: Inglês
10.1016/s0002-9378(40)90390-8
ISSN1097-6868
Autores Tópico(s)Colorectal Cancer Surgical Treatments
Resumo1.1. Transverse abdominal incisions for pelvic pathology are not widely used in this country as revealed in answers to a question-naire I sent out. 2.2. In my opinion these incisions are the safest and most logical approach to pelvic pathology when laparotomy is required. 3.3. The following advantages of this type of incision are stressed: 3.1.A. Almost complete absence of postoperative hernia and evisceration. Careful review of the literature reveals that these complications are essentially those of unphysiologic incisions, that is, incisions other than transverse. 3.2.B. Better scar. Incisions should be made along Langer's lines of skin cleavage. 3.3.C. Adequate exposure. The Pfannenstiel can be used in a preponderant number of cases and when one is familiar with this incision, he can usually get adequate exposure. The May-lard or Bardenheuer incision will give adequate exposure for any pelvic operation. 3.4.D. Better blood supply to wound with consequent better wound healing and lower incidence of wound infection. 3.5.E. Less tendency to adhesions. Some factor other than imperfect closure is responsible for the high incidence of adhesions following longitudinal incision. 3.6.F. Absence of lateral tension to wound. 3.7.G. Diminished morbidity and mortality with a shorter hospital stay and earlier return to physical work. 4.4. Seven hundred cases of transverse incision are reported without one instance of postoperative hernia or evisceration.
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