Types of abdominal and pelvic surgical incision

At the time of a surgical procedure, while making an incision a doctor has to take care of a number of factors before making an incision. Considering a number of factors, different types of incisions have come into fore, such as 

Midline Incision: It s the commonest incision and is done along the linea alba (fibrous structure running through the mid of the abdomen). These are preferred, especially in diagnostic laparotomy as it permits a wide access to the abdomen.
Pfannenstiel Incision: It is transverse in nature, extending from the umbilicus to the pubic-symphysis. It is generally employed for abdominal hysterectomy of benign nature and caesarean section.
Chevron Incision: It is an incision under the rib-cage and is done on the abdomen. It starts from beneath the ribs on the right abdomen and extends till the other mid axillary line. Thus, the entire abdominal width is incised for proper reach into the liver. The incision can be up to 2 feet.
Kustner Incision: It is transverse in nature and extends from the symphysis pubis till the iliac spine (anterior). This type of incision takes time to perform. A Pfannenstiel incision offers more exposure than a Kustner incision.
Lanz Incision: It is a variation of the more common mcburney-incision (also known as Gridiron s incision). It is generally used for open appendectomies. There are quite a few variations for this type of an incision.
Gridiron s incision: It is done for appendectomies. It is an oblique short incision which is done in the lower right quadrant in the abdomen.
Kocher s Incision: It is oblique in nature, extending from the abdominal upper right quadrant and is generally used for performing an open cholecystectomy. Gallbladder, biliary tract and certain liver operations can be suited for a Kocher s incision. This however is different from the same named incision used for the thyroid gland surgery.
Cherney Incision: It is transverse in nature. It allows a great range of exposure for the pelvic sidewall. It is less painful than a midline incision. It allows for the greatest pelvic exposure and hence is a widely preferred and practiced incision.

8 Types Abdominal and Pelvic Surgical Incisions

The outcome and the procedure of an abdominal laparoscopic surgery vary among patients. The extent of the surgery, the length of the procedure, the surgeon, the hospital nursing staff, and a number of other factors vary with each patient.

Moreover, the recovery or the healing time also varies among patients. What applies to one patient may not apply to another. Generally speaking, surgeons will tell you that it takes only a few days to recover from a laparoscopic surgery, but this is not true to specific cases as in many cases, the recovery time has been longer than expected. So, a laparoscopic surgery is subjective to the health of the patient and the extent of the procedure; however, there are some tips that may prove to be helpful for you to deal with a laparoscopic surgery and to improve your healing process.

Here are some useful tips that you can follow before the surgical procedure.

After you have consulted your doctor and made up your mind on the procedure, then it will be useful to watch some surgery videos and read about the procedure to prepare yourself mentally. The videos can be gory and hence discretion must be maintained.
You can read blogs by patients who have undergone laparoscopic surgery to get a better understanding of the procedure and its implications.
Eight hours prior to the procedure, do not drink or eat anything.
Ask someone to accompany you on the day of the procedure.
Make sure that you fix a pre-op appointment with the surgeon to clear any doubts about the surgery, anesthesia or any such concern.
You can shave the part of your body where the surgery will be performed by yourself or be prepared for someone else to do the same at the hospital.
Prepare your hospital bag with the necessary items and inform the person accompanying you about the items in your bag.
Here are some useful tips that you can follow after the surgery.

Keep yourself active after the procedure to enhance the healing process and to relieve any flatulence.
Stick to comfortable clothing and preferably loose clothes.
Avoid taking a bath for a week or as advised by your surgeon.
To avoid constipation and to stay hydrated drink at least 2-3 liters of water a day.
Hold a pillow against your stomach to lessen the pain while sneezing or coughing.
Don t get up straight from your bed. Roll sideways and use the support of your arm to stand up.
Avoid driving for at least 2 weeks.
Go for regular check-ups with your surgeon or doctor to ensure that the incisions are healing properly.

Tips To Deal With Abdominal Laparoscopy!

Ulcerative Colitis is a chronic inflammatory disease that affects the lining of the intestine and the rectum. It is located just above the anus. Patients suffering from ulcerative colitis tend to have small ulcers in their rectum and the colon. These eventually flare up leading to diarrhea, bloody stools, anemia and abdominal pain. The inflammation starts from the rectum and eventually, spreads to the colon. Ulcerative Colitis tends to flare up and remit in an alternate phase. The remission can last from few weeks to few years.

Methods adopted to diagnose Ulcerative Colitis-
Ulcerative Colitis is very similar to an inflammatory bowel disease known as Crohn s disease. The only differentiating factor is the fact that, ulcerative colitis affects the colon whereas, Crohn s disease affects the digestive system and the small intestine. A doctor might prescribe certain tests such as the colonoscopy, blood tests, CT scan, pill camera, stool sample tests etc.

Why is surgery necessary to treat Ulcerative Colitis?
An estimated 40 percent of all Ulcerative Colitis patients need to undergo surgery to recover completely. The reason surgery becomes necessary to treat ulcerative colitis are the following:

Drug therapy and medication become ineffective.
Without undergoing surgery, the condition might increase the risk of developing cancer.
The colon has the risk of getting ruptured if surgery is not performed on time.
There could be excessive bleeding.
Toxic megacolon might set in.
Types of surgery available to treat Ulcerative Colitis
A procedure where the entire colon is removed is known as the colectomy. In case both the colons are removed, the procedure is termed as proctocolectomy. In this procedure, an external pouch needed to be attached to the stoma that collects the stools. There is another method known as pouch surgery. 

Pelvic pouch or ileal pouch is also termed as IPAA. This procedure doesn t involve permanent stoma. In this procedure, both the colon and the rectum are eradicated from the body. The small intestine is then used to form a J-shaped pouch, that serves as the new rectum. The pouch is then connected to the anus. The whole procedure is done via two surgeries.

What are the surgical complications of this procedure?

There could be an excessive bowel movement.
There are instances where an inflammation of the pouch is observed. This condition is known as pouchitis.
There could be a situation of intestinal blockage from adhesion due to surgery.
There could be pouch failure that can happen inside within 5 few years. This is observed in 4 out of 100 patients who are treated. In this case, the patient should go for a permanent ileectomy.

Ulcerative Colitis - What You Need To Know?

Abdominal Laparoscopy is a surgical diagnostic procedure, which is used to examine the organs inside the abdomen. It is an invasive procedure, but only small incisions are made.
The procedure is usually done in the hospital and the patient is given general anaesthesia to make the procedure pain free. The laparoscope is inserted through an incision in the abdominal wall. As it moves along, the image of the inside of your abdomen is then seen on the monitor. After the exam, laparoscope and instruments are removed and the cuts are closed. Laparoscopy is usually done as an outpatient procedure. This means that you will be able to go home the same day.

Why Is laparoscopy performed?
Laparoscopy is often used to identify the source of abdominal pain. It is usually performed when x-rays or ultrasound are unable to determine the root cause of the problem. Laparoscopy allows your doctor to see inside your body in real time and helps to diagnose or help discover what the abdominal problem is.

Tips to deal with laparoscopic surgery

Before Surgery

    The first and the foremost thing is to prepare yourself for the surgery by watching some videos and going through some blogs on it as doing so will help you clear your doubts
    Do not eat or drink anything 8 hours before the procedure
    Make sure someone accompanies you on the day of the surgery
    Fix your Pre Op appointment to ask any questions or address any concerns regarding the surgery, anaesthesia, etc
    Shave the area where the surgery will be performed. This will substantially reduce itchiness
    Lastly, prepare your hospital bag and discuss it with the person who is going to accompany you so that he/she knows what all you packed

After Surgery

    Don t lie down in bed all the time. Keep yourself active by moving every two hours as it promotes healing and helps eliminate gas pain
    Wear comfortable clothing
    Do not take bath for a week. However, you can take a shower 24 hours post surgery
    Drink at least 1.5 to 2 litres of water per day to prevent constipation. If constipated, take a stool softener.
    While sneezing or coughing, hold a pillow against your stomach to lessen the pain
    Roll onto your side and sit up using your arms for support and then stand up
    Don t drive for two weeks
    Refrain yourself from intercourse, douching, and swimming
    Make sure to visit your doctor 2 to 3 weeks post surgery to make sure your wounds are healing

It might take some time for the wounds to heal, but in case of any prolonged pain do remember to consult your doctor immediately.

Easy Tips to Deal with Abdominal Laparoscopy

In most cases, pain anywhere in the body can be explained as a symptom of some other problem, but sometimes, there is no reason for abdominal pain. This type of pain is known as chronic functional abdominal pain. This is a gastrointestinal disorder that cannot be explained through X-ray or laboratory findings. It can be triggered by altered sensitivity to nerve impulses in the brain and gut. People suffering from this condition are often so debilitated by the pain that it becomes the central focus of their life.

This condition cannot be cured, but with proper treatment, it can be managed so that it does not affect the quality of your life. The aim of treatment for this condition is to control the symptoms and improve functioning. When it comes to treating this condition, the patient s relationship with his or her doctor plays an important role as the condition cannot be proven through any form of testing and it has a great psychological effect on the person. Regular checkups are also a key to managing this condition effectively.

The first step towards achieving this is to identify possible emotional and situational triggers. Maintaining a journal that records these experiences can help with this. Further treatment is usually either through psychological treatment or antidepressants.

Psychological treatment is based on the understanding that the brain can block pain by diverting attention elsewhere. Nerve impulses that travel from the abdomen to the brain must pass through a type of  gate  that is controlled by nerve impulses generated by the brain. When these impulses close the gates, pain is blocked while when these gates are open, the pain can be magnified. Psychological treatment for chronic functional abdominal pain can be in the form of relaxation techniques, imagery, hypnosis and cognitive behavioral therapy. While relaxation techniques such as meditation and hypnosis help a person shift focus from the pain, cognitive behavioral therapy teaches a person how to change thoughts and perceptions in order to control the pain.

Antidepressants can also act as pain relievers. This form of medication stimulates the production of brain signals that close the  gates  of nerve transmissions. This blocks the pain but can take several weeks to be effective. Some people may experience side effects such as drowsiness and nausea and hence should never be taken without a doctor s supervision. In some cases, antidepressants may also be combined with cognitive behavioral therapy or medication to regulate bowels.

Ways to Treat Chronic Functional Abdominal Pain!

Any type of surgery is stressful for your body and you will need to take extra care of yourself in order to heal well. Any procedure that is performed on the stomach, liver, gallbladder, intestines, appendix, pancreas or spleen can be categorised as an abdominal surgery. 

Here are ten tips to speed up the healing process after such a surgery.

Be prepared: While preparing yourself for surgery, also prepare your home for your return after surgery. Stock up your fridge with soft foods and keep loose, comfortable clothes easily accessible. Ideally, finish your laundry and house cleaning before the surgery and move away furniture and other things that could trip you.
Understand your medication: After the surgery, you are likely to be prescribed medication to relieve the pain and help with the healing process. Understand the dosage of these medications as well as any possible side effects that you should watch out for.
Get out of bed: The more you move around, the faster your incision will heal. Moving about also aids in the digestive process and helps the bowel work efficiently.
Avoid lifting heavy weights: Do not lift anything heavier than 500 grammes without your doctor s consent. This includes your pets, laundry baskets, grocery bags etc. also, avoid vacuuming for a while.
Get some light exercise: It may be a few months before you can get back to your regular workout routine but ensure that you get a little light exercise every day. Walking is a great way to start.
Keep plenty of pillows at hand: Holding a pillow between your knees or against your stomach can help relieve abdominal pain and discomfort. You may also feel better by propping yourself up on a few pillows when sitting on a chair.
Drink plenty of water: Keeping your body hydrated is crucial to the healing process. Water aids in circulation and ensures that adequate nutrients reach all parts of your body. Ideally, one should drink 8 to 10 glasses of water a day.
Care for your incision: Keep your incision clean and dry by washing it with soap and water daily and thoroughly drying it afterwards. Do not apply any ointment or cream on the area unless advised so by the doctor.
Take a close look at your diet: For the first few days, it is advisable to eat only soft or semi-soft foods that are easy to digest. You may gradually change to normal food as your body s tolerance levels increase.
Get plenty of sunshine: Exposing yourself to a little sunshine on a daily basis can make the recovery process less painful and make you more cheerful.

10 Quick Tips To Help You Recover Post Abdominal Surgery!

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