There are actually numerous incision types, possibly hundreds, that a surgeon needs to master. Two general categories of incisions are the vertical and the transverse incisions. As the name suggests, vertical incisions employ a top-to-bottom technique, while transverse incisions usually involves horizontal or slanting methods. To decide on the best incision types, a surgeon must consider three factors: accessibility, extensibility, and security. Accessibility means that the incision should allow the surgeon easy access to the organ that should be operated on, while extensibility and security mean that the cut can be enlarged, but still will not cause harm to nearby organs.
Under the vertical incision types is the midline incision, which is usually performed in the abdomen for various conditions concerning organs located in the area. The incision usually begins from the upper abdomen and ends just above the belly button. The advantages of the midline incision are that no muscles or nerves are damaged, it can be largely extended so organs are easily accessed, and it is less bloody, making the cut easy to close and be healed. The midline incision can also be performed for caesarean births, only the incision is done just below the mother’s belly button until before the pubic hairline begins. This caesarean incision is often done during emergencies to quickly get the baby out.
Another type of vertical incision is the paramedian incision, which is very similar to the midline incision except that the cut is done a little to the left or right of the center. This incision gives direct access to organs located at the side, such as the kidney and the spleen. It can, however, do some damage to the muscles and nerves in the area, and may produce more blood during surgery as the incision can sever more blood vessels.
For the transverse incision types, one of the most commonly performed is the Pfannenstiel incision, which is often seen in a caesarean section. The incision is made 2 inches (about 5 centimeters) above the mother’s pubic hairline, and once the skin is incised, another deeper incision is done at the exact location to open the uterus wall and extract the baby. This cut can also be done in surgeries concerning the prostate, bladder, and the reproductive organs.
The Kocher incision is a type of transverse incision that features a diagonal cut below the rib cage. The incision is often done for gall bladder surgeries, so the cut is often located on the right side of the torso. If two Kocher incisions are performed and shaped like an upside-down “V,” it is called a Chevron or a rooftop incision. There are some incision types that combine both the vertical and the transverse incisions, such as the Mercedes-Benz incision, named so because it features a similar shape to the car manufacturer’s famous logo. The incision features an upper midline incision that branches out into a Kocher incision, giving access to organs in the upper abdomen.