What are the types of surgical incisions?

October 2, 2025 •

2 min read

Millions of surgeries are performed annually, each beginning with a carefully planned surgical incision. Understanding what are the types of surgical incisions helps demystify the process and provides valuable insight into the precision involved in modern medical procedures.

Quick Summary

Surgical incisions are categorized primarily by location, orientation (longitudinal, transverse, oblique), and technique (open or minimally invasive). The specific type chosen depends on the required access, the underlying pathology, and patient-specific factors like anatomy and cosmetic considerations.

Key Points

Categorization: Incisions are broadly categorized as those for open surgery (larger cuts) and those for minimally invasive procedures (smaller port sites).
Location is Key: The location and orientation of an incision, such as the midline for broad abdominal access or the Pfannenstiel for pelvic surgery, are chosen based on the targeted area.
Factors for Choice: Surgeons select an incision type based on the required surgical access, urgency, a patient's anatomy, and the desire for a good cosmetic result.
Hernia Risk: Midline incisions provide excellent access but are associated with a higher risk of incisional hernias compared to transverse incisions.
Minimally Invasive Benefits: Laparoscopic and robotic incisions use small cuts, leading to less pain, faster recovery, and reduced scarring.
Healing Process: The way an incision is made, including aligning with natural skin tension lines, can significantly influence the healing process and scar formation.

Surgical Incision Categories: Open vs. Minimally Invasive

Surgical incisions are broadly categorized into those for traditional open surgery and those for minimally invasive surgery.

Open Surgical Incisions

Open surgery involves larger incisions to directly access internal organs. These classic incisions vary in location and direction based on the surgical site.

Minimally Invasive Incisions

Minimally invasive procedures, like laparoscopy, use several small incisions (port sites) for a camera and instruments. This method often results in less pain, reduced scarring, and quicker recovery.

Common Abdominal Incisions

Abdominal incisions are common and diverse, chosen to provide necessary exposure while minimizing tissue damage. Some common types include midline (vertical, center abdomen), Pfannenstiel (transverse, above pubic hairline), Kocher (oblique, below right rib cage), and McBurney (oblique, right lower abdomen).

Incisions for Thoracic and Cardiac Surgery

A median sternotomy is a vertical incision through the breastbone, common for open-heart surgery. A thoracotomy is an incision entering the chest cavity, typically between the ribs, used for lung or other chest procedures.

Specialized Incisions and Techniques

Specialized incisions exist for particular procedures, such as the Chevron incision (V-shaped across the upper abdomen) or the Lanz incision (horizontal for appendectomies). Robotic surgery also uses small incisions for instruments.

Factors Influencing Incision Choice

Surgeons consider several factors when selecting an incision, including surgical access, patient anatomy, healing/complication risk, cosmetic outcome, and urgency.

Incision Comparison Table: Abdominal Incisions

A comparison of abdominal incisions can be found at {Link: NCBI Bookshelf https://www.ncbi.nlm.nih.gov/books/NBK541018/}. This resource details incision types, locations, typical uses, and key advantages and disadvantages.

Conclusion

Surgical incisions are carefully chosen based on the surgical goal, patient-specific factors, and the need to balance access with recovery and cosmetic results. The choice of incision, whether for open or minimally invasive surgery, is a key element of surgical planning. For more details on surgical procedures, consult the {Link: National Center for Biotechnology Information https://www.ncbi.nlm.nih.gov/}.

Frequently Asked Questions

Surgeons consider multiple factors, including the type of procedure, the organs that need to be accessed, the urgency of the surgery, the patient's body size, the desire for a cosmetic outcome, and the potential risks of complications like hernias.

A midline incision is a vertical cut down the center of the abdomen, providing wide access for exploratory or trauma surgery. A Pfannenstiel is a horizontal, curved cut just above the pubic hairline, commonly used for pelvic procedures and favored for its cosmetic result.

Yes, laparoscopic surgery uses several small incisions, or 'port sites,' through which a camera and instruments are inserted. This differs significantly from the single, larger incision used in traditional open surgery.

Common abdominal incisions include the midline (vertical), Pfannenstiel (horizontal lower abdomen), Kocher (oblique upper abdomen), and McBurney (oblique right lower abdomen).

Yes, the type of incision can affect healing time. Incisions for minimally invasive surgery are smaller and often heal faster. For open surgery, incisions that follow the natural tension lines of the skin (Langer's lines) or split muscles rather than cutting them may also result in faster healing and less scarring.

A median sternotomy is a type of incision that runs vertically down the center of the chest, splitting the sternum. It is the standard approach for most open-heart surgeries.

Yes, surgeons will carefully consider the location of previous surgical scars when planning a new incision. Minimally invasive techniques can sometimes be advantageous in these situations as they allow access to unscarred tissue planes.