The transverse-vertical incision (Alazzam hybrid incision)

Moiad Alazzam,Abdallah Al-Ani,Mostafa Abdallah Khalifa

doi:10.1007/s00423-021-02404-5

Moiad Alazzam, Abdallah Al-Ani + Show 1 more

Open Access

https://doi.org/10.1007/s00423-021-02404-5

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Abstract

Open abdominal surgery evolved around two incisions, vertical and transverse incisions. Transverse incisions are associated with less postoperative morbidities but offer limited access. Vertical incisions offer better access but are associated with more complications. We describe here a hybrid incision, transverse-vertical incision that offers adequate exposure for complex lower abdominopelvic surgery while overcoming the limitations and morbidities associated with midline and transverse incisions.

Highlights

Abdominal surgery is an essential component for healthcare and requires a significant proportion of hospital resources
Following the publication of the Laparoscopic Approach to Cervical Cancer (LACC) trial in 2018 and the subsequent changes to surgical approach in particular cervical cancer, Alazzam hybrid incision was introduced in mid-2020 with the aim to overcome the potential morbidities from the midline and Maylard incisions
Throughout the literature, abdominopelvic surgeries were reported to be conducted using three different types of incisions including midline vertical incisions, suprapubic transverse incisions (i.e., Pfannenstiel, Maylard, and Cherney), and infra/ supraumbilical incisions [8], each of which is associated with a different profile of surgical advantages and postoperative complications

Summary

Introduction

Abdominal surgery is an essential component for healthcare and requires a significant proportion of hospital resources. Laparoscopy/robotic procedures are becoming more popular, still a significant proportion, the larger, more complex procedures, are performed by open technique[1]. Surgical access to the abdomen and pelvis can be achieved through multiple incision types, which can be broadly divided into either midline, including paramedian, or transverse, including oblique[2]. The type of abdominal incision can influence multiple outcomes. The choice of incision is usually based on the surgeon’s preference rather than the patient’s criteria. Ease of access, time to open and close the abdomen, and incidence of postoperative complications such as hernia and delayed recovery are important. The duration of operation and duration of hospital stay determine cost [2, 3]

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