Common Surgical Incisions

Common Surgical
Incisions
What is surgical incision?
Surgical Incision is a cut made through the skin to facilitate an operation or procedure. It should be
the aim of the surgeon to employ the type of incision considered to be the most suitable for that
particular operation to be performed. In doing so, three essentials should be achieved:
1.Accessibility
2. Extensibility
3. Security
Principles
• Incision should be long enough for good exposure
• Splitting is better than cutting
• Avoid cutting of nerves and vessels
• Retract muscle; abdominal organs towards neurovascular bundle
• Transverse incisions better than vertical incisions
• Close the wound layer by layer

Choice of Incision
Depend upon:
 Type of surgery [elective/emergency]
 Target organ
 Surgeons own experience and preference
 Previous surgery
The ideal incision allows:

 Ease of access to the desired structures Can be extended if needed
 Ideally muscles should be split rather than cut
 Heals quickly with minimal scarring
Langer’s Line
 Langer’s line corresponds to

the natural orientation of
collagen fibers in the dermis,
and are generally parallel to the
orientation of the underlying
muscle
 Incisions made parallel to
Langer’s Lines may heal better
and produce less scarring than
that cut across.
Surgical incision in the abdomen can be divided into:
1. Vertical Incisions
Vertical incisions: Midline incisions or median incisions: These incisions are made on the
midline of your abdomen. It is mostly favored in open surgery for diagnostic purposes
(laparotomy) because it allows wide access to all areas the abdomen and organs.
2. Transverse Incisions
A transverse incision 6cm above the pubic tubercle is made through the rectus abdominis
to gain access to pelvic structures. The incision is made through the rectus abdominis on
both sides, through the linea alba, and the medial aspects of the obliques
3. Oblique incisions
Several oblique incisions are used for specific organ exposures.
Common Surgical Incisions
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).

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.
8. Rutherford-Morison incision - similar

with the Gridiron incision but the surgeon
extends the incision into an oblique and
curvilinear orientation, facilitating access
to the ascending colon and sigmoid; also
used for kidney transplantation.
9. Pfannenstiel or pubic incision – is a type

of abdominal surgical incision that allows
access to the abdomen. It is used for
gynecologic and orthopedics surgeries,
and it is
ASSESSMEN
T TIME!
MODIFIED TRUE OR FALSE
Instruction:
Say the word TRUE if the statement is correct and if not, identify the
word or statement that makes the sentence incorrect and state the correct
word.
1. A transverse incision 6cm above the pubic tubercle is made through the
rectus abdominis to gain access to pelvic structures.
2. Midline incision is an oblique incision made in the right upper quadrant of

the abdomen, classially used for open cholecystectomy.
3. Lanz incision is the most common incision for laparotomy, a vertical incision
which follows the linea alba.
MODIFIED TRUE OR FALSE
4. Battle’s incision is a surgical incision used in appendectomies, with
temporary medial retraction of the rectus muscle.
5. Chevron incision is variation of the traditional Mc Burney’s incision. The

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.
References
Dr. Anita Dhanorkar, B. H. M. S. (2021, January 28). What are the types of
abdominal incisions? Procedure & complications. MedicineNet. Retrieved
March 4, 2022, from
https://www.medicinenet.com/what_are_the_types_of_abdominal_incisions/article.
htm
Google. (n.d.). Medical School rants. Google. Retrieved March 4, 2022, from
https://www.google.com/amp/s/medschoolrants.tumblr.com/post/149409983947/do
ctordconline-some-common-surgical-incisions/amp
Thank You !

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Common Surgical

• Splitting is better than cutting

• Avoid cutting of nerves and vessels

• Retract muscle; abdominal organs towards neurovascular bundle

• Transverse incisions better than vertical incisions

• Close the wound layer by layer

The ideal incision allows:

 Langer’s line corresponds to

1. Kocher’s incision – An oblique incision made in the

2. Midline incision or midline laparotomy- The most

6. Paramedian incision– provides laterality

7. Chevron incision( Transverse) This

8. Rutherford-Morison incision - similar

9. Pfannenstiel or pubic incision – is a type

2. Midline incision is an oblique incision made in the right upper quadrant of

5. Chevron incision is variation of the traditional Mc Burney’s incision. The

6. Paramedian incision provides laterality to the midline incision, allowing

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