Some common Surgical incisions and their indications
1. Kocher’s incision - An oblique incision made in the right upper quadrant of the abdomen, classially used for open cholecystectomy. It is appropriate for certain operations on the liver,gall bladder and biliary tract. This shares a name with the Kocher incision used for thyroid surgery: a transverse, slightly curved incision about 2 cm above the sternoclavicular joints..
2. Midline incision or midline laparotomy- The most common incision for laparotomy is the midline incision, a vertical incision which follows the linea alba. Midline incisions are particularly favoured in diagnostic laparotomy, as they allow wide access to most of the abdominal cavity.
3. McBurney incision - This is the incision used foro open appendectomy, it begins 2 to 5 centimeters above the anterior superior iliac spine and continues to a point one-third of the way to the umbilicus (McBurney’s point). Thus, the incision is parallel to the external oblique muscle of the abdomen which allows the muscle to be split in the direction of its fibers, decreasing healing times and scar tissue formation. This incision heals rapidly and generally has good cosmetic results, especially if a subcuticular suture is used to close the skin..
4. Battle’s incision – surgical incision used in appendectomies, with temporary medial retraction of the rectus muscle.
5. Lanz incision - A variation of the traditional Mc Burney’s incision. The Lanz incision is made at the same point along the transverse plane and deemed cosmetically better. It is typically used to perform an open appendectomy.
6. Paramedian incision– provides laterality to the midline incision, allowing lateral structures such as the kidney, adrenals and spleen to be accessed.
7. Chevron incision( Transverse) This incision a cut is made on the abdomen below the rib cage.
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An abdominal aortic aneurysm (AAA) is a swelling (aneurysm) of the aorta – the main blood vessel that leads away from the heart, down through the abdomen to the rest of the body.
The abdominal aorta is the largest blood vessel in the body and is usually around 2cm wide – roughly the width of a garden hose. However, it can swell to over 5.5cm – what doctors class as a large AAA.
Large aneurysms are rare, but can be very serious. If a large aneurysm bursts, it causes huge internal bleeding and is usually fatal.
The bulging occurs when the wall of the aorta weakens. Although what causes this weakness is unclear, smoking and high blood pressure are thought to increase the risk of an aneurysm.