title: [Individualized or standard approach to the abdomen : Currently available data].
abstract: BACKGROUND
  Every abdominal incision can lead to early (e. g. abdominal infection) and late complications (e. g. hernia). The correct incision is often important to have optimal access to the surgical area and to keep complications low.
  
  
  OBJECTIVE
  An analysis of the recent literature was carried out to clarify which access routes have advantages over other types of incision.
  
  
  METHODS
  A literature search was carried out in the following databases: Cochrane database of systematic reviews (CDSR), Cochrane library, Medline and PubMed. Systematic reviews and studies with large numbers of cases were used for the evaluation, whereas studies with small numbers of cases and case reports were not taken into account.
  
  
  RESULTS
  Midline incisions are the first choice for acute and elective abdominal surgery because of a good view into and rapid access to the abdominal cavity. For large upper abdominal operations transverse incisions can be considered of equal value due to excellent exploration possibilities, e.g. of the liver and pancreas. 25 years after the introduction of laparoscopy, this technique has become established for cholecystectomy, fundoplication and bariatric surgery. For appendix and colon surgery laparoscopy has the advantage of being less traumatic, whereby postoperative pain and hospitalization are reduced but under circumstances longer operating times must be expected. The single incision laparoscopic surgery (SILS) technique is beneficial in cosmetic outcome; however, incisional hernias, prolonged operating times and higher complication rates are limiting factors for this technique. Natural orifice transluminal endoscopic surgery (NOTES) and atypical incisions are rarely used.
authors.affiliation: Krankenhaus und Geriatriezentrum, Sozialmedizinisches Zentrum Floridsdorf, Hinaysgasse 1, 1210, Wien, Österreich. hollinsky@aon.at.
authors.forename: C
authors.initials: C
authors.lastname: Hollinsky
mesh_terms: D006801:Humans; D010535:Laparoscopy / Q000379:methods* / Q000592:standards*; D007813:Laparotomy / Q000379:methods* / Q000592:standards*; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods* / Q000592:standards*; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D057285:Precision Medicine; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000209:etiology / Q000517:prevention & control
keywords: Abdomal wall; Laparoscopy; Laparotomy; Natural orifice transluminal endoscopic surgery; Postoperative pain