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

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!

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

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 pain can be triggered by a number of factors. Sometimes, it's mild enough to be overlooked while at others, the pain can be debilitating. Most abdominal problems start with the same symptoms and hence the cause of this pain can be a little difficult to pin point. In many cases, the location of the pain can help understand the factors that are triggering it.

Generalized pain can be simply be triggered by indigestion. On the other hand, it could also be a symptom of a number of illnesses like irritable bowel syndrome, appendicitis, viral gastroenteritis and intestinal obstructions etc. However, the former are more common. This type of pain resolves itself without medical intervention.

In other cases, abdominal pain can be localized to the upper or lower abdomen on the right or left side or in the centre of the abdomen. This sort of pain is usually sporadic and comes and goes with great intensity. In most cases, this sort of pain is a symptom of a serious problem and should not be ignored. One of the most common examples of localized abdominal pain is the pain caused by appendicitis in its later stages. Severe pain that is located just above the centre of the belly button could be a sign of pancreatitis. A burning sensation and severe cramps in the center of the stomach could point towards stomach ulcers that could cause perforations if left untreated. Other causes for this type of pain include endometriosis, ovarian cysts, angina, kidney infections and a spleen infection.

Mild stomach pain whether localized or general can be relieved using home remedies and does not often require medication. However, if the pain is severe or if it comes on suddenly, you must immediately consult a doctor. Another reason to consult a doctor is if the pain persists for more than 24 hours. If the pain is accompanied by black or bloody stools or vomiting and nausea, do not ignore it. Black stools are often an indicator of the presence of blood in the digestive tract. Abdominal pain that worsens with movement or is tender to touch is also something that should be shown to a doctor. Other reasons to consult a doctor are abdominal pain with persistent vomiting following meals and unexplained weight loss and a loss of appetite.

The bottom line is, that when it comes to abdominal pain, it's better to consult a doctor and be told that there's nothing to worry about rather than self medicate and wait for it to worsen.

Abdominal Pain & When To Consult A Doctor

Dyspepsia is an uncommon word, but a very common problem. This medical condition is more commonly known as indigestion of the stomach and small intestine. The symptoms of this condition include abdominal pain, bloating, belching, nausea and a loss of appetite. They come and go varying terms of frequency and intensity. 

Some of the common causes of dyspepsia are lactose intolerance, anxiety, regurgitated stomach juices, stomach ulcers, irritable bowel syndrome and excessive caffeine or alcohol intake. In most cases dyspepsia can be easily treated with home remedies. 

Here are the 5 best ways to treat it.
1. Lemon juice: Lemon juice cleanses the digestive system by flushing out waste material and undigested food. It also inhibits the formation of acids in the stomach and boosts appetite. Dilute the juice of 1 lemon in a glass of water to avail its benefits. You could also add half a teaspoon of fresh ginger juice to this. Ginger also aids in digestion and prevents flatulence.

2. Buttermilk: Buttermilk has cooling properties and helps calm the stomach and intestines. It is also suitable for people who are lactose intolerant. Drink a glass of buttermilk immediately after a meal to improve your digestion. You could also flavor it with roasted cumin powder or mint. Mint also helps in relieving indigestion and prevents buildup of gases in the stomach while cumin stimulates the secretion of pancreatic enzymes.

3. Yogurt: Yogurt is the best remedy for any stomach bug. It is rich in probiotics that help restore balance healthy gut bacteria and stabilize digestion. Yogurt can be had as an accompaniment to your meals or mixed with steamed rice to make it a meal in itself.

4. Fenugreek: Fenugreek boosts appetite and helps relieve indigestion. This herb is known for its soothing properties that cleanse the digestive system. Fenugreek leaves can be bitter and unpalatable. Hence, to benefit from this, boil the leaves and then lightly fry them in butter before eating them.

5. Pomegranate juice: Pomegranate juice is an excellent way to treat indigestion and diarrhea. Its antioxidant properties also make it a good remedy for heartburn. To benefit from pomegranate juice, dilute the juice of a pomegranate in a glass of water along with a tablespoon of honey.

Along with this, also take a look at your eating habits. Avoid eating on the move and chew your food properly. Eat only when you are hungry and control your portion sizes. Lastly, make the time to exercise for half an hour or so every day.

What Is Dyspepsia? 5 Best Ways to Treat It

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