13.01.14 Surgical scars

Abdominal scars - summary

Complete list

1 - Kocher's Incision

• • Biliary surgery eg. Cholecystectomy

  • Hepatic surgery (may also require a larger transverse incision for wider access: eg. Liver Transplant)

2 - Upper Midline laparotomy

• • Nissens fundoplication

    • • observe: associated with Gastrostomy tube?

  • Upper GI surgery

2a - Lower / Long Midline Laparotomy Scars

• • Any major abdominal surgery

3 - Transverse Upper Abdominal Incision

• • Repair of congenital diaphragmatic hernia

  • Splenic surgery

4 - Ramstedt's Pyloromyotomy Scar

• • Ramstedt's Pyloromyotomy Scar - treatment of Pyloric Stenosis

5 - Grid-Iron Incisions at McBurney's Poiint

• • Appendicectomy

    • • A non-inflamed appendix should always be removed once this scar has been made so that clinicians are not mislead in the future.

      • Called the 'Grid-Iron' incision due to the way the muscle layers are divided at operation.

      • McBurney's Point: the junction of the distal third and proximal two thirds of the line between the umbilicus and the anterior superior iliac crest.

6 - Umbilical / Sub-umbilical Scars

• • Hernia repairs

  • Gastroschisis repair

  • Exomphalos

7 - Point incision marks

• • Laparoscopy port sites

  • Drain sites

  • Also consider abdominal wound sites for Ventriculo-Peritoneal shunts

8 - Inguinal Incisions

• • Inguinal hernia repairs

  • Vascular access scars

9 - Lateral Thoracolumbar Incision

• • Renal Surgery - eg. Nephrectomy

10 - 'Hockey-Stick' scar

• • Examine for orthotopic renal transplant