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The Cherney incision is an
incision Incision may refer to: * Cutting, the separation of an object, into two or more portions, through the application of an acutely directed force * A type of open wound caused by a clean, sharp-edged object such as a knife, razor, or glass splinter * ...
used in gynecologic surgery. It is similar to the
Pfannenstiel incision A Pfannenstiel incision , Kerr incision, Pfannenstiel-Kerr incision or pubic incision is a type of abdominal surgical incision that allows access to the abdomen. It is used for gynecologic and orthopedics surgeries, and it is the most common m ...
but allows access to the space of Retzius and gives a larger area in which to operate. __TOC__


Technique

The Cherney incision begins when the skin is cut 2-3 centimeters above the
pubic symphysis The pubic symphysis is a secondary cartilaginous joint between the left and right superior rami of the pubis of the hip bones. It is in front of and below the urinary bladder. In males, the suspensory ligament of the penis attaches to the pubi ...
and the surgeon dissects down to the
rectus abdominis muscle The rectus abdominis muscle, ( la, straight abdominal) also known as the "abdominal muscle" or simply the "abs", is a paired straight muscle. It is a paired muscle, separated by a midline band of connective tissue called the linea alba. It exte ...
. The surgeon then uses blunt dissection with the fingers to separate the tendons from the overlying fascia before cutting the tendons 1-2 centimeters above the pubic symphysis. The muscles are then lifted away, toward the patient's head (cephalad). Then, the
peritoneum The peritoneum is the serous membrane forming the lining of the abdominal cavity or coelom in amniotes and some invertebrates, such as annelids. It covers most of the intra-abdominal (or coelomic) organs, and is composed of a layer of mesot ...
can be cut and the surgery can proceed.


Complications

Complications can ensue. If surgical retractors are not placed carefully under the edges of the incision, they can damage the
femoral nerve The femoral nerve is a nerve in the thigh that supplies skin on the upper thigh and inner leg, and the muscles that extend the knee. Structure The femoral nerve is the major nerve supplying the anterior compartment of the thigh. It is the largest ...
or other nerves in the area. If during wound closure, tendons are sewn directly to the pubic symphysis, osteitis pubis or
osteomyelitis Osteomyelitis (OM) is an infection of bone. Symptoms may include pain in a specific bone with overlying redness, fever, and weakness. The long bones of the arms and legs are most commonly involved in children e.g. the femur and humerus, while the ...
can result.


References

{{Reflist Surgical procedures and techniques Surgical incisions