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SF018/#632 Maylard incision: a transverse incision for complex gynecologic surgery

Introduction Maylard incision is a transverse abdominal incision characterized by the ligation of inferior epigastric vessels and the transection of rectus abdominus muscles. It provides a good surgical exposure. The aims of this video is to detail Maylard incision technique. Description A transverse skin incision is made four cm above the symphisis pubis. After dissection of subcutaneous tissus, transversalis fascia is openned. Rectus abdominus muscles are separated from the fascia. Inferior epigastric vessels are located at the external edge of rectus abdominus muscles. They are dissected, ligated and cutted. The rectus abdominus muscles are sectionned using bipolar device. The parietal peritoneum can be openned. After the surgery, the parietal peritoneum is closed using a running suture. Rectus abdominus muscles can be autres but it is not mandatory. Conclusion Maylard incision provides a good surgical exposure, a cosmetic, reproducible technique with less complications and pain comparing to midline incision. Hands on training are required to perfom this technique.