Pfannenstiel incision

Pfannenstiel section (N. J. Pfannenstiel) - suprapubic cosmetic transverse incision of the skin and subcutaneous tissue when, chrevosechenie. Incision Pfannenstiel used in many gynecological operations; in cancer of the cervix and body of the uterus, ovarian cancer it is not recommended.
Incision Pfannenstiel conduct cross over to the pubic joint (2-3 cm above it) in the form of a slightly curved bottom line natural suprapubic the crease, which corresponds to the upper boundary of pubic hair. Skin and subcutaneous tissue is cut with a scalpel spreads all through the length of 12-15 cm (Fig. 1). The aponeurosis of the cross cut and cut extend in both directions from the white line curved scissors in parallel and therefore the length of the skin incision to the outer edge of recti (Fig. 2). The top and bottom Edges of the aponeurosis capture clips in the middle section and usepreview from subject-muscle maximum up to the navel and 1-2 cm down to fold. The aponeurosis is separated from the underlying muscles easy, except for the area of the white line, where fascial spike between pussy direct muscle is more dense (Fig. 3). Rectus muscles easily be separated by blunt, parietal peritoneum is cut longitudinally.
After the operation, the parietal peritoneum and direct the abdominal muscles are sutured, as for longitudinal cut; the aponeurosis usually sewn interrupted sutures of catgut, while ensuring that the correct contact its edges, especially on the ends of the cut - in that place where the aponeurosis split into three leaves. Skin with subcutaneous tissue sew usually, as in the longitudinal section.
After the healing of the wound a thin linear scar, which is covered by hair and largely masked suprapubic fold. The scar has no inclination to calloused thickening and pigmentation. Postoperative hernia when chrevosechenie on Pfannenstiel rare that is a great advantage of the cut Pfannenstiel compared to the median longitudinal incision. Cm. also Laparotomy.

Fig. 1. Cross suprapubic incision of the skin and subcutaneous tissue,
Fig. 2. A cross-section of the aponeurosis.
Fig. 3. Department aponeurosis from direct stomach muscles.