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Published on: December 23, 2022
Incisional hernia after upper abdominal surgery: a randomised controlled trial of midline versus transverse incision
1Department of General Surgery, Erasmus MC, University Medical Center Rotterdam, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands. jenshalm@hotmail.com
Summary
For cholecystectomy, a transverse incision significantly reduces incisional hernia risk and improves cosmetic outcomes compared to a midline incision. This study suggests transverse incisions are a preferable alternative when laparoscopy is not feasible.
Area of Science:
- Abdominal Surgery
- Surgical Incisions
- Cholecystectomy
Background:
- Incisional hernias are a common complication following abdominal surgery, particularly with midline incisions.
- Alternative surgical incision techniques may reduce hernia incidence and improve patient outcomes.
Purpose of the Study:
- To compare the incidence of incisional hernias between transverse and midline incisions in cholecystectomy.
- To evaluate surgical site infections, postoperative pain, hospital stay, and cosmetic results.
Main Methods:
- A randomized controlled trial involving 150 female patients undergoing cholecystectomy.
- Patients were allocated to either a transverse or midline incision group.
- Outcomes assessed included early complications, discharge duration, analgesic use, and long-term incisional hernia development.
Main Results:
- Incisional hernia incidence was significantly lower in the transverse incision group (2%) compared to the midline group (14%).
- Transverse incisions were shorter and associated with better cosmetic results.
- Midline incisions led to more reported postoperative pain in the initial days.
Conclusions:
- Transverse incisions represent a viable and potentially superior alternative to midline incisions for cholecystectomy when laparoscopic surgery is not an option.
- Consideration of transverse incisions may decrease incisional hernia rates and enhance patient satisfaction.
