The McBurney incision has largely been supplanted by the Rockey-Davis incision, which is oriented transversely as opposed to obliquely, allowing for better. Rockey-Davis incision. Transverse skin incision in right lower quadrant with muscle splitting technique used in appendectomy. Cases have been seen in which an abdominal incision extends from the xyphoid process to the . Transverse or Davis-Rockey Incision (fig ‚Äč(fig10)10) ().

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Prentice Hall International Inc. But these have to be removed later after the healing process has been completed. Obstetrics Gynaecology 91 2: The extraperitoneal fat is abundant davls vascular in this area, and small vessels here need to be coagulated with diathermy. The legendary superior strength of the pfannensteil incision: An attempt has been made to add the latest modifications in a concised manner.

Personal notes on operative surgery were also used. The Fowler-Weir approach davs appendicectomy. The skin can then be reflected as necessary to expose the internal and the external rings. The subcostal incision is started at the midline, 2 to 5 cm below the xiphoid and extends downwards, outwards and parallel to and about 2.

What needs to be done is to widen the ring at the groin, where the loop was initially trapped and then grab with a Babcock forceps the loop of bowel from the inside of the abdominal cavity and with a gentle traction pull out the loop from the widened internal ring for inspection.


In intestinal obstruction, distended bowel loops may be there rockye below the incision and in re-exploration, the bowel may be adherent to the peritoneum. Any of the appropriate upper abdominal incision can be combined with a thoracotomy incision to form a thoraco-abdominal incision. In such circumstances, it is very difficult, or indeed impossible to dissect the rectus nicision away from the rectus sheath.

Journal of the Anatomical Society of India

The Rocky-Davis incision provides another option. If necessary for exposure, the ligament can be divided between clamps and ligated.

Care must be taken to avoid ‘tramline’ or ‘acute angle’ incisions Figure 1which could lead to devascularisation of tissues. These principles apply to both open and laparoscopic incisions.

Consideration should be given wherever possible, to siting the incisions in natural skin creases or along Langer’s lines.


It is necessary to separate the aponeurosis in an upward direction, almost to the umbilicus and downwards to the pubis.

Surgical incision for caesarean section. British Journal of Obstetrics and Gynaecology; 91 1: The paramedian incision can be mucle- retracting or muscle-splitting 18. McBurney originally placed the incision obliquely, from above laterally to below medially. International Journal of Inciion Cancer, 9 5: Alternatively, vertical incisions may be placed in a paramedian position, an approach that was previously more popular than it is today but continues to have its proponents.

Author information Copyright and License information Disclaimer. This is one of the earliest incisions for appendicitis. This transverse incision is preferred by many for the removal of appendix because it gives a better dsvis on healing and the incision can easily be extended medially during surgery if needed.



Extension across the midline and down the other costal margin may be used to provide generous exposure of the upper abdominal viscera.

An alternative to subcuticular closure is to close the skin incision using vertical-mattress-alternatingwith- simple suture method. Transverse and oblique incisions can be placed in any of the four quadrants of the abdomen depending on the site of pathology. British Journal of Surgery, 67 6: This site uses cookies to provide, maintain and improve your experience.


Southern Medical Journal Apr; 88 4: After ligation of the phrenic vessels in the line of the incision, the diaphragm is divided radially Zinner et al, In general, re-entry into the abdominal cavity is best done through the previous laparotomy incision.

British Journal of Surgery, 62 4: This incision is usually made parallel with the course of the fibers of the external oblique inciaion, one or two inches cephalad to the anterior superior rofkey of the ilium.

The basic rule in surgery is to make an incision big enough and adequately placed to allow a comfortable access to the area of operation. Those patients with an anterior appendix are usually easier to manage through a small incision, as opposed to retrocecal appendices which require an extended incision. Edr10th Edn.