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 abdomen houses multiple organs and pain in the abdomen could indicate a problem with any of these organs. From a medical point of view, the abdomen and associated pain can be divided into nine areas or quadrants the right, middle and left sideways and the upper, middle, and lower quadrants from top to bottom. The doctor would usually ask the patient to point to the area of the problem for instance, right lower quadrant or upper left quadrant.

With a mental mapping of the organ in each of these quadrants, the diagnosis is arrived at, with confirmation by imaging if required. Some of the most common causes for lower abdominal pain are listed below, and the kidneys are important organs in this area.

Lower left abdominal pain is caused because of the problems in the large intestine, small intestine, spleen, left kidney, ureter, ovaries, fallopian tube, urinary bladder and their associated structures.
Some of the common issues in this area could be menstrual cramps, urinary tract infections (UTIs), left kidney stones, uterine disorders, intestinal obstruction, ectopic pregnancy, constipation, colon cancers, pelvic inflammatory disorder, Crohn s disease, inguinal hernia, and a ruptured spleen.
Lower right abdominal pain can be due to appendicitis, right inguinal hernia, UTI, right kidney stones, colon cancer, menstrual cramps, uterine disorders, intestinal obstruction, ectopic pregnancy, pelvic inflammatory disorders, diverticulitis, Crohn s disease, endometriosis, and lymph node inflammation.
As is evident from this list, many of these are related to the urinary tract and kidneys. Whether it is the kidneys per se, the urinary bladder, the ureters, or the associated nerves and blood vessels, UTIs are very common. And if one of these organs is affected, then the chance of the infection spreading to the surrounding organs is very high. There is a constant flow of urine through these structures, and so the infection can pass through easily.
A person who has had kidney problems would have very characteristic symptoms. The pain would be in the lower back, on either side of the spine, depending on which side is affected. While the pain experienced due to kidney stones is acute and can be stabbing in nature, the UTI would appear in bouts. The associated symptoms should always be kept in mind when identifying and treating kidney problems.
There could be nausea, diarrhoea, blood in the urine, fever, profuse sweating and severe fever, which could help in discovering the problem.
These should not be ignored and diagnosis should be confirmed with blood tests and imaging including X-rays and CT scans. The treatment would depend on the condition, and early identification of the problem leads to better prognosis and a simpler treatment.

Lower Abdomen Pain - Can It Be A Sign Of Kidney Problem?

As soon as one is released from hospital after going through an abdominal surgery, the patient must make a checklist and an early recovery strategy before leaving home. Do follow the following tips and recover soon.

Do make prior arrangements for a safe and comfortable journey back to home. Ensure that you have made transportation arrangements to go home safely. Use your own car or book any cab or take any friend s help. Place a cushion over your abdomen to keep it safe from jerks.

Do go for post-surgery checkup. Book an appointment with your surgeon post-surgery. This would ensure that surgery did not cause any side-effect.

Understand the schedule for taking medicines. Usually the patients are given painkillers. If you think you are not getting relief from it then ask your surgeon to prescribe you an alternative. Patients are likely to suffer from constipation post an abdominal surgery. If that happens, intake more fibrous food, fluids and indulge in light physical activities. Patients can also ask for cheaper alternative medicines.

Check for certain signs and symptoms and take adequate steps:

Take adequate sleep. There are chances that you may feel dizzy and fatigue, therefore one must observe change in sleep patterns. Have patience. Things will become normal in due course of time.

You will also be subjected to little pain from the incision. Take your medicines as directed in order to get an early relief from pain.

Draining of yellow color liquid from the incision in little quantities post the surgery is normal. If the drainage continues even after 7 to 14 days with redness around incision, it is a clear symptom of infection. Consult your surgeon immediately for the cure.

Removal of urinary catheter from the bladder may cause minor difficulties during urination. Situation will become normal in few days. If discomfort persists, consult your surgeon.

Identify the following dangerous symptoms and call your doctor right away.

Persistent vomiting or nausea

Incapability to digest food or fluids

Swelling in leg

Abnormal body temperature

Infection at the surgical site

Maintain a healthy and supervised lifestyle post surgery.

It will take few days to return to your normal routine life. So have patience until then.

Go for morning and evening walks. Avoid heavy exercises as such activities may cause physical strain.

Take care of your surgical incision

Surgical incision should be regularly cleaned or washed gently. Try to keep the surgical site dry until the stitches are removed.

After 5-7 days of surgery, the stitches would be removed by the surgeon. Avoid putting ointment on the stitches until then. It will take few weeks for the scars to fade.

Under proper care and supervision, the patient will soon recover post an abdominal surgery and will be able to get their life back on track.

Abdominal Surgery - Tips To Recover From It!

There is hardly any individual across the world, who has not experienced abdominal pain. In most instances, these aches are not very serious and can be diagnosed and treated by addressing the underlying condition. It is very crucial to recognize the symptoms which are severe and know when an individual should seek medical assistance. 

Most common causes of abdominal pain: 

Some of the most common causes of abdominal pain include Indigestion, infection, menstrual cramps. It may also be due to food poisoning and allergies, irritable bowel syndrome, gas formation and bloating, lactose intolerance, pelvic inflammatory disease or ulcers and hernia, gallstones and kidney stones, urinary tract infection, Crohn s Disease or gastroesophageal reflux disease. 

Some patients have abdominal pain but the source of pain lies in the spine. These patients are often seen by multiple doctors and have undergone many tests but their diagnosis is never established. These patients should visit a pain specialist to reach a diagnosis and treatment plan. They have conditions like neuropathies or facet joint arthritis which cause abdominal pain due to a condition known as referred pain. 

Symptoms of abdominal pain that are cause for concern: 

Abdominal pain along with any sign of dehydration or fever or is unable to pass stools.
Abdominal pain associated with tenderness in the abdomen, painful and frequent urinations or persistent loose motions or bloody/ tarry stools. 
Severe or recurrent abdominal pain. 
Determining the cause of abdominal pain and treating it.

Detailed medical history and thorough physical examination would be performed. Further tests like USG, Endoscopy etc may be needed to reach a diagnosis. 
The treatment of abdominal pain is entirely dependent on the cause of the pain.

Abdominal Pain - Know the Causes Behind It!

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!

Infection is generally understood as the invasion into the body tissues of an organism by certain foreign bodies such as bacteria, parasite, and virus. They are transmissible diseases and can be transmitted from one person to the other via sneezing, coughing or physical contact. They can be mild, moderate or severe.

*They can be acute, that is, can last for a short time, or chronic that lasts for a long time, or a latent infection that may not cause any symptoms at first but reactivates and resurfaces over a period of time.

* Although each infection has its own distinct symptom. Generally, these symptoms include fever, swelling, redness, inflammation, burning, cough, diarrhea, fatigue, muscular pain, nausea, vomiting, rapid pulse or rapid breathing.

* If the patient has a severe headache, difficulty in breathing, painful swelling and unexplained prolonged fever or cough, he or she should immediately consult a doctor.

Conventional drugs that are given to treat infections like antibiotics, antiviral, antihistamines and steroids have many side effects on the human body. They on one hand hamper the digestive power of the system and on the other hand lower the immunity power of the body. In the long run, these medicines can have adverse effects on the body. Though conventional drugs suppress the disease for some time, the disease tends to resurface in the future.

However, Homeopathy has been found to be of great success in treating both acute and chronic infections. The best part is that, there is no side effect. Homeopathy also boosts our immune system so that the body naturally develops the strength to fight against infections in future, when foreign bodies invade. Homeopathic medicines have also proved to be effective as preventive measures against infections.

Some of the Homeopathic medicines for the treatment of most common infections are discussed below:

1. Throat infections - Belladonna, Lachesis, Lycopodium, Phytolacca, and Mercurius are most commonly administered to cure throat infections.
2. Skin infection - Common homeopathic remedies are Sulphur, Calendula, Hypericum, Silica, and Hepar sulfuris.
3. Bladder infection - Berberis, Chimaphila, Hydrastis, Apis, Cantharis, and sarsaparilla are commonly prescribed.
4. Stomach infection - Arsenic album, Nux vomica, Carbo veg, Lycopodium, and Pulsatilla are commonly recommended.
5. Sinus infection - Kali bichromicum, Pulsatilla, Mercurius, Natrum muriaticum, and Allium cepa work well in cases of sinus infections.

Most of the Homeopathy medicines are prescribed on the basis of symptoms observed. So, Homeopathic medicines are prescribed, even before the definitive diagnosis is made. Thus, the time saved prevents the infection from spreading, and the patient is automatically cured rapidly.

Homeopathy Treatment For Infections

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