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Vertical incision vs. bikini incision Vertical incision vs. bikini incision

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Unread 06-23-2004, 07:53 PM
Verticle incision vs. bikini incision

Hi Everyone,

My surgery is sch. for June 29 TAH/BSO and my Dr. told me she will be doing a verticle incision. She said because it was easier to get my tumor and cyst out that way, they are quite large. I Would love to know from all of you who have had surgery what is the difference and what was the reason for one or the other of the incisions?
Thanks, rdj40
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Unread 06-23-2004, 07:59 PM
Vertical incision vs. bikini incision

I am not truely sure but I know that vertical incisions are hardly ever used. Maybe you should try another dr for a different opinion. If they agree keep the sch sugery. If not then talk to your dr about it.
Unread 06-23-2004, 08:14 PM
Vertical incision vs. bikini incision

I have to dissagree that vertical incisions are hardly used. my surgeon is at the top of his field (oncology) and his explanation for doing a vertical incision is that it is easier to view everything from a vertical incision. If he did a bikini incision and found other things wrong (like cancer), he may have difficulty doing everything he would have to do with a bikini.

Fortunately, my cyst was benign. Since Im 49 and dont wear bikinis anymore, I said go for the vertical incision and have a real good look around!
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Unread 06-23-2004, 08:15 PM
Vertical incision vs. bikini incision

Thanks for your reply. This Dr. is my 2nd opinion but I do think I will talk to her again about it.

Thanks, rdj40
Unread 06-23-2004, 09:18 PM
Vertical incision vs. bikini incision

I had a total hysterectomy on 5-19 and I had a vertical incision as my uterus was enlarged with fibroids and that is how she had to take it out. I am fine with what she chose to do, as she is the doctor. My stitches still were removed a week later and the scar looks fine.
My girlfriend had hers done 15 years ago and hers was also vertical and she had a normal sized uterus, just wanted to go with another scar she had.
Unread 06-23-2004, 09:23 PM
Vertical incision vs. bikini incision

When I asked my Dr. about the direction of the incision, she told me the same thing, that it depends upon the easiest way to get everything done. My incision was horizontal because my very large uterus was laying against the nerves going into my legs, and she couldn't get to it with a vertical incision. She does both, though. She is a good doctor, she and I talked for nearly an hour about surgery in general, and she answered so many of my questions!
Unread 06-23-2004, 09:24 PM
Vertical incision vs. bikini incision

When I went in for my pre-op, my Doc informed me he would be using a vertical incision. I was shocked, but when he explained that if he used the "standard" bikini cut and then found that he needed more room, he would also have to make the vertical- IN ADDITION TO! I had very large fibroids, and they couldn't rule out cancer, so he needed a big veiwing area. I said go vertical- and it's been just fine. As a matter of fact, my daughter had 2 C-secs with a bikini cut and thinks that my recovery with a vertical was easier, and I agree!
Unread 06-23-2004, 09:24 PM
Vertical incision vs. bikini incision

My doctor went in first with a laproscope to check everything out - all organs up and down, and made sure everything would come out through the horizontal Ibikini) incision. I thought that was an excellent idea - I was saved from a vertical incision, and all it cost me was an extra tiny incision in my belly button (just added to the 5 already in there!)
Unread 06-23-2004, 09:28 PM
Vertical incision vs. bikini incision

i had a vertical incision because my fibroids and mass of blood vessels were huge...and my dr says that they do the vertical incision mostly because they dont know what the ovaries look like and its easier to get to them that way....and sometimes, if they do the bikini incision and things are worse than they thought, they actually have to do the horizontal incision as well....and then you'd have both incisions to heal from, and i dont think that'd be fun.....

i'd just talk to ur dr about your concerns or questions and decide from there....good luck..

Unread 06-24-2004, 07:15 AM
Vertical incision vs. bikini incision

My doc is also one of the leaders in his field, and is the director of the Minimally Invasive Surgery department here at the U-M in Ann Arbor. He advocates laparoscopic surgery when it is possible, and when doing laparotomies, advocates bikini incisions. However, because of my situation, he opted for a vertical incision. So, I will also disagree with the statement that vertical incisions are rarely done anymore. Perhaps that statement is correct when it comes to your standard run-of-the-mill hysterectomy, but I didn't have one of those, and it doesn't sound like yours is run-of-the-mill, either, due to the size of your "aliens."

These are the reasons my doc chose a vertical:
  • Stage IV endometriosis (in order to get way back in the cul-de-sac and other out-of-the-way places, it is a lot easier with a vertical)
  • The size of my endometriomas and placement (they were on each ovary, and each was about 10cm). The "distal third" of my ureters were not seen on the MRI or the CAT scan, so they weren't sure what they would find. As it turns out, the ureters had "tunneled through" the cysts, and had to be "skeletonized"
  • Size of my uterus - mine was about twice the normal size.
  • Concern for adhesions as my pelvis was "frozen" (My bladder was bound to my ovaries, pelvic wall, uterus, cervix - the cysts/ovaries were bound to the pelvic arteries, as well as the pelvic wall, recto-sigmoid, uterus, cervix - my uterus/cervix was bound to the bladder, the cysts/ovaries, the bowel). Recto-sigmoid was being "strangled" by adhesions.
  • If there is any possibility of cancer, they will do a vertical, as they need that room for staging. They had no reason to think that I had any malignancies, but with the size of the cysts, they wanted to be sure.

So, they knew a lot going in with me, but they were surprised with what they actually found. But, Katlover has a point. If there is any doubt as to which incision to use, perhaps they can go in with a laparoscope and have a look-see to prevent you from having a vertical if at all possible (my doc had suggested that until he did my manual exam and found out I had a frozen pelvis - that "cemented" his decision to use a vertical - pun intended).


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