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Related Experiment Videos

Peritoneal closure after lateral paramedian incision.

J M Gilbert, H Ellis, S Foweraker

    The British Journal of Surgery
    |February 1, 1987
    PubMed
    Summary

    The lateral paramedian incision is a strong choice for abdominal surgery, eliminating burst abdomen risks. Closing the peritoneum is unnecessary for this incision, reducing incisional hernia rates.

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    Area of Science:

    • Surgical techniques
    • Abdominal surgery
    • Wound healing

    Background:

    • The lateral paramedian incision is considered robust for abdominal surgery.
    • The necessity of closing the deep peritoneal layer requires evaluation.

    Purpose of the Study:

    • To assess the efficacy of the lateral paramedian incision.
    • To determine if peritoneal closure is required with this incision.

    Main Methods:

    • A prospective randomized trial involving 206 patients undergoing laparotomy.
    • Patients were randomized to have the peritoneum closed or left open.
    • Wound integrity was assessed postoperatively for up to 2 years.

    Main Results:

    • No cases of burst abdomen were observed.
    • Zero incisional hernias occurred when the peritoneum was closed; one occurred when left open.
    • Seven incisional hernias (13%) occurred in patients excluded from the trial.

    Conclusions:

    • The lateral paramedian incision effectively prevents burst abdomen.
    • Incisional hernias are rare with this approach.
    • Peritoneal closure is not necessary for the lateral paramedian incision.

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