Orris

Appendectomy explain in short easy way its incision names

Reading File
Finding Sources
Searching PubMed

appendectomy incision

Searching the Web

appendectomy incision McBurney Lanz gridiron incision surgical reference

Appendectomy means surgical removal of the appendix, usually done for appendicitis.

Incisions used

Open appendectomy
  1. McBurney incision / Gridiron incision
    • Most common traditional incision.
    • Oblique cut in the right lower abdomen.
    • Made near McBurney’s point, about one-third of the way from the right hip bone to the umbilicus.
    • Muscles are split rather than cut widely.
  2. Lanz incision
    • A horizontal incision in the right lower abdomen.
    • More cosmetically acceptable because it follows skin lines.
    • Often used instead of the McBurney incision.
  3. Lower midline incision
    • Vertical cut in the lower middle of the abdomen.
    • Used if diagnosis is uncertain, infection is widespread, or the surgeon needs wider access.
Laparoscopic appendectomy
  • Usually 3 small “keyhole” cuts:
    • At or near the umbilicus
    • Above the pubic bone
    • In the left lower abdomen
Easy memory:
  • McBurney = oblique
  • Lanz = transverse/horizontal
  • Midline = vertical
The NIH surgical-incision reference describes the gridiron incision as the McBurney incision.

Explain the layers of a McBurney incision

Reading File
Finding Sources
Searching PubMed

appendectomy incision

Searching the Web

McBurney gridiron incision layers external oblique internal oblique transversus fascia peritoneum

Layers of McBurney (Gridiron) incision

From superficial to deep:
  1. Skin
  2. Superficial fascia
    • Fatty layer: Camper’s fascia
    • Membranous layer: Scarpa’s fascia
  3. External oblique aponeurosis
    • Cut in the direction of its fibres.
  4. Internal oblique muscle
    • Fibres are separated/split, not usually cut.
  5. Transversus abdominis muscle
    • Also split along its fibres.
  6. Transversalis fascia
  7. Extraperitoneal fat
  8. Parietal peritoneum
    • Opened to enter the abdominal cavity.
Important point: McBurney incision is a muscle-splitting incision. The internal oblique and transversus muscles are separated in the direction of their fibres, helping preserve muscle strength. Current Surgical Therapy, Open Appendectomy, describes splitting the three muscle layers until the peritoneum is reached.

Rutherford

Reading File
Finding Sources
Searching PubMed

appendectomy incision

Searching the Web

Rutherford Morison incision appendectomy incision extension gridiron

Rutherford Morison incision

Also called the hockey-stick incision.
  • It is an extension of a McBurney/gridiron incision when more space is needed.
  • Used in difficult appendicectomy, appendicular abscess, mass, or when wider access to the right lower abdomen is required.
  • The internal oblique and transversus abdominis muscles are cut in the line of the skin incision, unlike the usual McBurney incision where they are split.
  • This gives wider exposure but causes more muscle damage.
Layers:
Skin → superficial fascia → external oblique aponeurosis → internal oblique (divided) → transversus abdominis (divided) → transversalis fascia → extraperitoneal fat → parietal peritoneum.
Memory:
McBurney = muscle splitting
Rutherford Morison = muscle cutting for wider exposure
Bailey and Love’s Short Practice of Surgery, Surgical technique: conventional appendicectomy, notes that a gridiron incision may be converted to a Rutherford Morison incision by cutting the internal oblique and transversus muscles.
This is a shared conversation. Sign in to Orris to start your own chat.