[Choose midline incision for the best access to the abdominal cavity]

A midline incision or a wide transverse incision offers good access to the abdominal cavity. A midline incision should probably be preferred. Then no major nerve, muscle or vessel is severed and thereby subsequent neural or abdominal wall dysfunction may be avoided. Both incisions seem to be associated with similar pain, although a subcostal incision may be advantageous for gallbladder surgery. Respiratory function may be better with transverse incisions but there is no randomised study comparing incisions when a postoperative epidural is used. Wound dehiscence rates have not been proven to differ and the rate of incisional hernia is similar with both types of incision.