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

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

Measures to be taken before surgery for fast recovery from Abdominal Surgery.

Ancillary measures

Take regular walks several times daily to prevent blood clots and help the bowels moving.
Avoid climbing the stairs every day, at least for the first ten days. 
Avoid strenuous exercise such as lifting, carrying, pulling, or moving heavy objects (more than 5 pounds) until your surgeon advises as it may open the sutures due to pressure. Avoid lifting anything over a certain weight for at least six weeks after your operation.
Maintaining a good posture will help your wound heal correctly. Use a comfortable pillow while sitting to give rest to the operated site.
Take good sleep and proper rest for a quick recovery as most of the repair and healing occurs during sleep.
Avoid straining with bowel movements by eating a high-fiber diet or taking stool softeners to avoid constipation.
An abdominal binder can also help with the recovery process. These help keep everything in place and can decrease the possibility of a hernia.
A gradual return to work may be advised because sudden resume to work may cause opening of sutures and delay the process of healing.
Use table that easily wheels away from the bed but can also straddle the bed. This will allow you to read, use the computer, and eat without putting any pressure on your stomach or twisting around.
Cough and sneeze carefully by applying pressure to the incision with your hands or a pillow to avoid reopening of the surgical incision.
Improper dressing or not maintaining hygiene during dressing and keeping dressing unchanged for a longer period of time may lead to infection which may cause delayed healing. Thus, in order to prevent this a gentle wash with soap and water is required to avoid infection.
Dietary measures

A protein-rich diet should be consumed in order to hasten wound healing.
Have a liquid diet with lots of vitamins as vitamin C and zinc help with healing. Also, include B12 and Iron   as both aid bone marrow in forming new blood cells.
Intake of Fiber and probiotics help boost the immune system and also keeps your digestive tract moving along.
Have plenty of water-this will help the recovery process and removal of toxins from the body.
Try sitting in the sunlight as it will help with getting some extra Vitamin D.
Keep control over sugar levels if you are diabetic as increased levels of sugar in the blood helps bacteria to grow rapidly. This will further lead to infection and delay the process of healing.

Abdominal Surgery - Recovery Tips!

Appendicitis is a chronic or acute medical condition where the appendix gets inflamed and causes severe pain.  If left untreated, the condition can prove to be fatal. The appendix is a small tube-shaped sac at the end of the large intestine. In humans, it is typically not known to have any functional value although some studies suggest that it helps digestion by creating a conducive environment for friendly bacteria.

Surgical removal of the appendix is suggested as the most common treatment for the ailment. But homeopathy treatment for appendicitis issues is also available. One of the key causes of appendicitis is believed to be the partial or complete obstruction at the mouth of the appendix.

The common causes of obstruction include accumulation of fecal matter, worms, enlarged lymphoid follicles, trauma, or tumors. It is also possible that an infection in the stomach could have extended into the appendix.

Appendicitis can be treated with homeopathic medicine, it is commonly detected because of its progressive worsening pain in the stomach which narrows down to the lower right side of the abdomen is called Mc Burney point. Half of the patients though do not have this typical symptom and instead come in with a complaint of gastroenteritis, urinary tract infection, or even a kidney stone.

Further blood tests, urine tests, and MRIs or ultrasounds are used to pinpoint the area causing the pain. In most cases of the advance appendix, surgical intervention is necessary. The type of surgery will vary on a case to case basis.



Homeopathic Treatment for Appendicitis Pain
Homeopathy remedies can be tried in the early stages and are especially useful to treat chronic and recurrent cases. It works with the principle of 'like cures like', which means that the elements that cause the problem are a key to its solution too. It employs a holistic healing methodology getting rid of the signs and symptoms and restoring complete health. While other treatments focus on curing the 'problem', homeopathy also deals with the basic reason for the Appendicitis problem and the individual's susceptibility to it.

Homeopathic Medicines for Appendicitis Symptoms
Arsenicum album: This homeopathic cure for appendicitis is used when appendicitis has resulted in sepsis and the patient also suffers from diarrhea.
Belladonna: This is an early stage remedy for cases where appendicitis is accompanied by headache, fever
Bryonia alba: This homeopathic remedy for appendicitis is very effective when the pain aggravates with movement. 
Colocynthis: In appendicitis homeopathy treatment this home remedy "Colocynthis" used when the patient experiences spasmodic or entwining pain, which worsens with indigestion. Applying warm pressure over the area helps in such cases.
Rhus Tox: This natural home remedy is also called the 'homeopathic knife' to treat appendicitis. It is used when the pain is constant and the patient is never free from pain.
To customize the selection of the homeopathic remedies according to your specific symptoms, it is best to consult with a practitioner.

Update From Lybrate: To keep your Gut Health on track and to avoid constipation and gastric troubles, We suggest you to buy Gut Care products available on Lybrate GooKart at affordable prices.

Homeopathy Treatment & Medicine for Appendicitis Pain

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!

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