Description

In oncological pelvic surgery a median incision is generally preferred above the in 1900 described technique by Pfannenstiel because of the better exposure. There are two main disadvantages of a median incision: a weak and cosmetically ugly scar. In a median scar a wound hernia develops in 3% of the cases, 10 times more frequent than after a transverse incision. The cosmetic disadvantage is evident. In 1907 Maylard introduced an interspinal transverse incision with a transversal cleavage of the rectus muscle and transverse opening of the peritoneum. This method combines an attractive cosmetic scar with excellent exposure of the operating field, which allows extensive lymphnode dissection, including the paraaortic region. At closure of the abdominal wall the cleaved muscle is not sutured. The Maylard incision is suitable for extended oncological, but also non-oncological lower abdominal operations by surgeons, urologists and gynaecologists. Our own experience includes more than 50 patients. Because of the mentioned advantages the Maylard incision deserves more frequent use in the field of gynaecological, urological and other pelvic surgery.