Incisions for Obesity Surgery: a brief report

Any incision should give exposure to the organs to be operated; any incision should also ensure correct healing, and last, but not least, the incision should leave an aesthetic scar. The most widely used abdominal incision for obesity surgery is vertical midline, which causes some pain and has an incidence of hernia. Transverse incisions are good, but do not give good exposure to the field as an obese patient is operated. The oblique sub-costal incision is easy to perform, gives an excellent view of the upper abdominal organs, and does not cause much pain in the postoperative period. In 452 patients, 72 were operated with vertical midline incision and 380 with left oblique incision. Gastric bypass was the operation done in all cases. Immediate postoperative ventilation was good in most patients, but seven of the first (vertical) group required a ventilator for 12-36 h. Patients of the second (oblique) group did not require the ventilator, except for one case with Pickwickian syndrome. Three patients with vertical incisions developed a hernia, and only one in the second group (oblique). It appears that the oblique incision is better than vertical incision for obesity surgery.