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[Morley inter-iliac transverse incision in gynecologic operations]
R J Lellé1, W Heidenreich, H J Lück
1Frauenklinik der Medizinischen Hochschule Hannover.
Abstract:
The Morley incision is much less frequently used than the Pfannenstiel technique. Dividing the rectus muscle during laparotomy has both the advantages of the Pfannenstiel incision (good exposure of the pelvic organs, cosmetic appearance, decreased risk of hernia formation) as well as those of the midline approach (access to the upper abdomen). Between October 1992 and April 1994, the Morley technique was used in 73 cases. In 33 patients, radical hysterectomy with pelvic lymphadenectomy for cervical carcinoma was performed. In 40 patients, the Morley incision was used for treatment of carcinoma of the endometrium (20), ovarian masses (16), large fibroids (3) or marked obesity (1). The rate of secondary wound healing was 10%. On patient required hernia repair. No postoperative bleeding and no haematomas were observed. The Morley technique is an excellent alternative to the standard midline incision whenever optimal exposure of the pelvic viscera is required as well as an acceptable access to the upper abdomen.
Insights
The Morley incision offers excellent pelvic and upper abdominal exposure, combining benefits of Pfannenstiel and midline approaches. This surgical technique is a viable alternative for gynecologic procedures requiring broad access.
Area of Science:
- Surgical techniques in gynecology
- Abdominal surgery
Context:
- The Pfannenstiel and midline incisions are standard surgical approaches.
- The Morley incision, involving rectus muscle division, is less commonly utilized.
- Evaluating alternative surgical methods is crucial for optimizing patient outcomes.
Purpose:
- To assess the efficacy and safety of the Morley incision in gynecologic surgery.
- To compare the advantages of the Morley incision with established techniques.
- To determine the suitability of the Morley incision for various gynecologic conditions.
Summary:
- The Morley incision was used in 73 gynecologic cases between 1992 and 1994.
- Procedures included radical hysterectomy, endometrial cancer treatment, ovarian mass removal, and myomectomy.
- The technique demonstrated a 10% rate of secondary wound healing and one hernia repair, with no observed bleeding or hematomas.
Impact:
- The Morley incision provides optimal exposure of pelvic viscera and acceptable upper abdominal access.
- It serves as a valuable alternative to standard midline incisions for complex gynecologic procedures.
- This approach may enhance surgical outcomes and patient recovery in specific clinical scenarios.