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

Everyone can suffer from pain in the stomach, at one time or the other and we usually ignore it. But when the pain is sudden and severe abdominal pain then it is termed as acute pain and this should not be ignored.

Often the following can be expected with acute pain:

Acute abdomen pain is usually synonymous with rapid onset of the symptoms which might indicate life threatening intra-abdominal pathology.
Pain is just a feature and not necessary that it is present at all times. An acute abdomen which is pain free usually occurs in children and women who are in their third trimester of pregnancy.
The differential diagnosis is difficult and wide especially in primary care. This is because the different organs within their peritoneal cavity might have different areas of referred pains.
Abdominal pain usually happens to be in the top three symptoms when patients present their state in the emergency and accident departments. But only few of these have acute abdominal pain.
Management of the abdominal pain should be the primary focus and an assessment should be done to reach the differential diagnosis so that care can be given accordingly.
The clinical evaluation regarding abdomen pain can change quickly. Any diagnosis which had been made can change and both doctor and patient should not be hesitant and seek other treatment.
Conditions which might cause acute abdomen pain are:

Meckel's diverticulitis or Acute appendicitis
Acute cholecystitis
Ectopic pregnancy
Acute pancreatitis.
Peptic ulcer disease
Diverticulitis.
Intestinal obstruction, including paralytic ileus (adynamic obstruction)
Pelvic inflammatory disease.
Gastrointestinal (GI) haemorrhage
Gastroenteritis.
Acute intestinal ischaemia/infarction or vasculitis.
Acute urinary retention
Renal colic or renal tract pain
Testicular torsion
Abdominal aortic aneurysm
Non surgical diseases like pericarditis, sickle cell crisis, acute intermittent porphyria, HIV-associated lymphadenopathy, bowel disease, typhoid, opiate withdrawal, enteritis, pneumonia, myocardial infarction and hepatitis.
Rare causes might include thromboemboli, phytobezoar, and phytobezoar
Diagnosis of abdominal pains:

Patients can be ordered to get their blood tests done. Also if need be then imaging can also be referred to them.
Following tests can be done to rule out the condition causing the abdominal pain:
Blood Tests: these include FBC, LFTs, glucose, amylase, clotting, calcium and arterial blood gas for pancreatitis
Crossmatch or group and save
Pregnancy test in women of childbearing age
Blood cultures
Peritoneal lavage in case of an abdominal trauma
Urine analysis
X ray of the abdomen, ultrasound, CT scan
ECG and cardiac enzymes
Laparoscopy should be a routine procedure

Don't Ignore the Acute Abdominal Pain

Infants often suffer from certain diseases which need proper care and timely treatment for quick recovery. At times, it can be difficult to communicate with an infant and understand his/her needs and problems but with a close observation you will surely be able to detect any alteration in the baby's behavior and sense it when he/she is ill. Here are some of the most common diseases infants are susceptible to and what you can do about them.

1. Abdominal distension
It is normal for a baby's belly to stick out after he/she has been fed, but if between feedings there is swelling in the abdomen or it feels hard, it can be an indication of a problem. If this symptom is accompanied by vomiting and absence of bowel movements for more than two days, your baby may be suffering from abdominal distention. This condition may have been caused by swallowing of extra air by the baby while crying or feeding. In such a situation, a pediatrician should be consulted for proper diagnosis and treatment.

2. Jaundice
It is common among newborns to develop mild forms of jaundice as the undeveloped liver is often not able to eliminate the chemical bilirubin from the blood. Mostly, this situation proves to be harmless till the level of bilirubin reaches a certain limit. After that, the disease must be properly treated to avoid damage to the baby's brain or nervous system.

3. Rsv infection
Rsv or respiratory syncytial virus is responsible for causing respiratory problems among infants. Rsv infection usually affects the bronchial passage and shows symptoms like cough, runny nose and mild fever which may even lead to bronchitis. Moreover, this infection may also develop into viral pneumonia, which makes it more important to consult a pediatrician if your baby shows any of the above symptoms.

4. Diarrhea
Infants are susceptible to watery bowel movements due to the action of virus, allergens, specific medications or bacteria. If you observe that your baby is passing stools more often than usual and it is watery, then it may be a case of diarrhea. Sometimes, these symptoms are accompanied by high fever, abdominal pain, lethargy, vomiting, dry eyes and mouth etc. In this situation you should consult your pediatrician and focus on replacing the fluids your baby has lost, to prevent dehydration.

4 Common Diseases that Babies are Susceptible To

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!

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?

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.

Tips to Recover from an Abdominal Surgery

Don't wait any longer, manage your Biliary Cirrhosis online with a Lybrate doctor today

Consult for Biliary Cirrhosis - Online and Easy!

FilterClear All

COMMON SPECIALITIES

COMMON ISSUES