Vertical vs. horizontal incision

I am due for total abdominal hysterectomy 4/10/02 and my doctor request that he'd be allowed to do a vertical incision instead of a horizontal as I wanted. I have very large fibroids and he felt that he could do a better job with the surgery by doing vertical. I can't find research on this topic but I have heard that horizontal incision makes recovery so much easier and your not left with a stomach that looks likes it is folding in on itself. Anyone have a take or experience on this?

Hi,

I don't know about healing better, but I think it looks better.

My DR is doing vertical. He said because of the enlarged uterus. Plus, that way if they decide to take lymph nodes they can.

I did a little research and he confirmed this. In a vertical, they cut with the muscles, up & down. So they are only separating the muscles, not cutting them in half!

Don't know about the horizontal.

Debbie

The horizontal is also called the bikini incision, because it's just above the pubic bone. Usually they don't actually cut muscles in either surgery, the skin and fascia layers are cut, then they use wound spreaders (look like big salad tongs or shovels) to spread the muscles and allow access to the abdomen.

I had the bikini cut, my uterus was much larger than expected and presented my DR with a challenge to get it out through the incision.

The following is from a site called The Pelvic Floor. This site shows pictures from actual surgeries,

"It has to be made clear that the smallest or most inconspicuous incision, is NOT always the best. Unfortunately I can't explain here why that is, but trust me, its true. Or better yet, don't trust me at all; ask your own doctor...

It is important to note that NO abdominal muscles are usually cut. The rectus muscles are separated from one another, and spread apart, using the retractor. The bowel is then carefully packed upward and out of the surgical field, using swabs"

Here is a link to the site, with a warning, IT IS GRAPHIC, not for the faint of heart!!
http://www.pelvicfloor.com/library/library.html

I had a horizontal cut at my request. The doctors told me it would be easier for them to do the surgery with a vertical incision but easier for me to heal with a horizontal one. Since I have had both kinds twice with kids, I chose the horizontal one. They also were concerned because of the fibroids. The uterus had to be free moving once I was put out. Then the actual choice of incision would be based on that. Since I didn't have fibroids, but adeno instead, they cut me horizontally. I was in surgery for 3 hours, but I healed up quickly! I'm 6 weeks post tomorrow and I feel wonderful!!!!!!!!!

Sara

I had a bikini line incision. My surgeon had done a very neat cut and stitched well, there is a ridge on the incision but this is getting better. The stitches were removed four days after my op as the incision had healed very quickly. I would definitely recommend it.