Other Known Aliases – Kerr incision
Definition – 8-10cm transverse (slightly arched) incision made 2-3cm cephalad to the pubic symphasis. The rectus sheath is then retracted cephalad and the rectus abdominis muscle bellies are divided longitudinally to enter the peritoneum
Clinical Significance – This is the primary incision for cesarean sections because it follows the Langer Lines and can achieve excellent cosmetic results. There are also decreased rates of postoperative pain, fascial dehiscence, and incisional hernias noted.
History – Named after Hans Hermann Johannes Pfannensteil (1862-1909), who was a German gynecologist and received his medical doctorate from the University of Berlin in 1885. He was an extraordinary surgeon and teacher and published extensively on many gynecological conditions. In 1900, he published an article describing the the advantages of his eponymous transverse fascial incision for gynecologic laparotomies. Dr. Pfannensteil unfortunately died from septicemia at the age of 47 after injuring his finger draining a tubo-ovarian abscess.
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- Pfannenstiel HJ. (On the advantages of the symphyseal transverse fascial incision for gynecological caliotomies as well as the contribution to the surgical indications). Samml Klin Vortr. 1900;268:1735-56