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Modified Makuuchi incision for major upper abdominal surgeries.

Narendra Pandit1, Laligan Awale1, Shailesh Adhikary1

  • 1Division of Surgical Gastroenterology, Department of Surgery, BP Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal.

Polski Przeglad Chirurgiczny
|December 19, 2019
PubMed
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The modified Makuuchi incision is effective for major upper abdominal surgeries, offering adequate exposure and improved surgical ergonomics. This surgical approach demonstrated a low incidence of complications like surgical site infections and incisional hernias.

Area of Science:

  • Abdominal Surgery
  • Surgical Incisions

Background:

  • Various abdominal incisions exist, but optimal choice for major upper abdominal surgery remains debated.
  • Standardized approaches are needed to improve outcomes in complex abdominal procedures.

Purpose of the Study:

  • To audit the efficacy of the modified Makuuchi incision in major upper abdominal surgeries.
  • To evaluate surgical ergonomics, exposure, and complication rates associated with this approach.

Main Methods:

  • Retrospective audit of surgical data from three centers (March 2014 - December 2018).
  • Analysis of 144 patients undergoing major upper abdominal surgery utilizing the modified Makuuchi incision ('J' or 'L' variations).
  • Assessment of intraoperative findings and postoperative outcomes, including surgical site infection and incisional hernia rates.
Keywords:
J/L incisionmodified Makuuchi incisionupper abdominal surgery

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Main Results:

  • The modified Makuuchi incision provided adequate exposure and enhanced surgical ergonomics in all cases.
  • Surgical site infection occurred in 13.2% of patients, and incisional hernias in 4.2% over a mean follow-up of 27.78 months.
  • Incision extension was rarely required (2 patients).

Conclusions:

  • The modified Makuuchi incision is an efficacious surgical option for major upper abdominal procedures.
  • The technique offers a favorable balance between adequate surgical access and acceptable complication rates.