Interneural and intervascular extension for increased exposure in midline vertical incisions

Area of Science:

• Surgical technique
• Abdominal surgery
• Anatomy

Background:

• Standard midline incisions are insufficient for wide upper lateral abdominal exposure.
• Inverted "U" incisions can compromise abdominal wall neurovascular supply.

Purpose of the Study:

• To describe a novel interneural and intervascular abdominal incision.
• To evaluate its efficacy in providing superior lateral abdominal exposure while minimizing complications.

Main Methods:

• The interneural and intervascular incision extends from the costal margin medially, joining a vertical midline incision.
• A triangular abdominal wall flap is raised.
• The technique was assessed in a series of seven patients.

Main Results:

• The interneural and intervascular incision provided superior lateral abdominal exposure.
• No cases of wound hernia or delayed wound healing were observed postoperatively.
• The approach adheres to anatomic principles by paralleling nerve and vascular distribution.

Conclusions:

• This interneural and intervascular incision is a safe and effective alternative for procedures requiring extensive upper lateral abdominal access.
• It minimizes postoperative pain and promotes optimal wound healing by respecting abdominal wall anatomy.