B. Stephens Dudley, MD, FACS; Kesha Robertson, MD; Marco Jarrett, MD
The demand for cosmetically pleasing abdominal incisions in gynecology is great. However, if there is any suspicion of malignancy, then upper abdominal access is important in the staging process.
Several incisions have been developed in gynecology but all have limitations. The Pfannenstiel incision limits access to the upper abdomen and the Maylard and Cherney incisions have significant morbidity with the division of the rectus muscle or tendon. Kustner described the transverse incision in the skin and fat with vertical incision in the fascia and peritoneum in 1896.
This video depicts the Kustner incision technique in a 50 year old female with a uterine mass suspected of being a fibroid. However, because of her age, leiomyosarcoma was possible.
This video shows that the Kustner incision is an attractive alternative to the other standard cosmetic incisions in gynecology.