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Where is the best skin incision for partial resection of the small intestine?
Hidejiro Kawahara1, Kazuhiro Watanabe, Takuro Ushigome
1Department of Surgery, Kashiwa Hospital, Jikei University School of Medicine, 163-1 Kashiwashita, Kashiwashi, Chiba 277-8567, Japan. kawahide@jikei.ac.jp
Background/Aims:
For partial resection of the small intestine for benign disease such as Crohn's disease, a large incision has been placed in the mid-abdomen, for which ideal location and its length remain to be clarified. This study evaluated the validity of anthropometric placement of such an incision for partial resection of the small intestine.
Methodology:
Thirty consecutive patients with advanced rectal cancer (Age 30-82 {mean 60.1} years, 15 men and 15 women) who underwent anterior resection by open surgery between 2005 and 2006 were studied. The position of the viscera was projected on the anterior wall of the abdomen in relation to the umbilicus.
Results:
The position of each viscera (Xcm, Ycm) was as follows; Duodenojejunal flexure (1.3 +/- 1.3, 9.4 +/- 2.1) and ileoceal valve (-7.3 +/- 1.0, -2.8 +/- 1.7). The small intestine which is not fixed to the retroperotoneum was located between the duodenojejunal flexure and the ileoceal valve.
Conclusion:
The ideal location of a small skin incision for small intestinal lesions is above the umbilicus for jejunal lesions, and below the umbilicus for ileal lesions.
