Abdominal incisions used for most gynaecologic procedures can be divided into transverse or vertical incisions. Because of the ease and rapid entry, the abdomen was originally routinely opened by the longitudinal incision in linea alba. Transverse incisions were generally avoided as they are time consuming along with fear of haemorrhage and retraction of recti. First successful abdominal operation was performed by McDowell in 1809 by the vertical infra-umbilical incision.
Generally, vertical incisions provide excellent exposure and rapid entry. Length is not the limit; they can be easily extended further if required in unexpected situations. The vertical incision cuts the skin perpendicular to the ‘Langer lines’ which run horizontally across the lower abdomen, thus the resulting scar remains wide compared to transverse incisions.
Although vertical incisions are not the cosmetic ones but is good for emergency cases, and cases where haemorrhage has to be identified and checked, which is commonly the requirement in obstetrics and gynaecology.
