[Transverse laparotomy by supre-pubic detachment of the recti muscles in gynecologic surgery. Apropos of 266 cases]. / Laparotomie transversale par désinsertion sus-publenne des droits en chirurgie gynécologique. A propos de 266 cas

ABSTRACT

The authors have studied 266 case histories where supra-pubic detachment of rectus muscles was used according to Cherny's method. This allowed aseptic gynaecological surgery to be carried out in all its forms by a true transverse incision. The advantages are great it is aesthetic and the incision can be enlarged if necessary indefinitely. This means that surgery can be carried out easily and explains the great rarity of intra-abdominal complications. On the other hand two relatively rare complications do occur with this incision peritoneal haematomata and lateral herniations. Details have been given of the methods necessary to avoid these complications.

ABSTRACT

PIP 266 cases in which suprapubic detachment of the recti muscles was performed according to Cherney's method were studied. This method, which is described and compared with other methods, allowed aseptic gynecological surgery to be performed in all its forms by a true transverse incision. This technique offers great advantages, both from an esthetic viewpoint and because, if necessary, the incision can be enlarged indefinitely. Thus, surgery can be performed easily, which explains the great rarity of abdominal complications. Conversely, 2 relatively rare complications do occur when using this incision peritoneal hematoma and lateral inguinal hernia. The techniques required to prevent the occurrence of such complications are described in the report. There is a single formal contraindication, in case of septic lesion; if, however, such lesions are found unexpectedly during the operation, the appropriate technique to be followed is described. The incision should be avoided in the case of patients suffering from obesity and blood disorders, because of the risk of hematoma.