The T or L Incision in Resection of Tumors of the Pelvis

Abstract

For tumors of the pelvis, a midline incision is commonly used, starting from above the umbilicus and continuing around the umbilicus down to the pubic symphysis. The incision is deepened through the subcutaneous fat, and the linea alba is incised on the entire length of the incision to the pubic symphysis. The linea alba is found exactly at the midline more easily close to the umbilicus. The peritoneum also is incised, but this can be done only for the upper portions of the incision, starting from the superior end and then around the umbilicus down to the junction of the middle and lower third of the infraumbilical portion of the midline incision. The reason for stopping the incision at this point is because the peritoneum at that level is splayed around the urinary bladder, so it cannot be divided straight all the way to the pubic symphysis.