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Gibson Incision

Urologic Indications

In urology, a gibson incision is used for renal transplantation or as an extraperitoneal approach to the distal ureter with low morbidity. The gibson incision cannot be extended easily in case of unexpected intraoperative situations.

Preoperative Patient Preparation

• Patient positioning: supine position
• General anesthesia
• Perioperative antibiotic prophylaxis, if risk factors for wound infection are present

Surgical Technique of a Gibson Incision

• Skin incision see fig. gibson incision
• Cut through the subcutaneous fat tissue and Camper's fascia to expose the aponeurosis of the external oblique muscle of the abdomen.
• Split the aponeurosis of the external oblique muscle in direction of the fibers. Insertion of retractors, cut the internal oblique muscle of the abdomen in direction of the muscle fibers. Cut the transverse abdominal muscle in direction of the muscle fibers. The lateral edge of the rectus sheat should be reached.
• Using blunt dissection, the peritoneum is pushed superiorly and medially.

Gibson incision: the incision starts 2 cm medial to the spina iliaca ant. sup. and is continued (3 cm cranial to the inguinal ligament) to the lateral border of the rectus sheat.

References

  Deutsche Version: Schräger Unterbauchschnitt nach Gibson