Maylard Incision in Gynecologic Surgery: 4-Year Experience in Thammasat University Hospital(cid:31)
Sakol Manusook MD*, Komsun Suwannarurk MD*, Densak Pongrojpaw MD*, Kornkarn Bhamarapravatana PhD**
Affiliation : (cid:31) The abstract of this manuscript was presented on April 24-26, 2014 as poster presentation at The World Congress on Building Consensus out of Controversies in Obstetrics, Gynaecology & Infertility (COGI) & the XII Annual Meeting of the Mediterranean society for Reproductive Medicine (MSRM), Barcelona, Spain * Department of Obstetrics and Gynecology, Faculty of Medicine, Thammasat University, Pathumthani, Thailand ** Department of Preclinical Science, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
Objective : To present the results of Maylard incision for gynecologic surgery in Thammasat University Hospital during the
past four years.
Material and Method: A retrospective study of gynecologic surgery performed via the Maylard muscle cutting incision
compare to Pfannenstiel muscle splitting and midline incision. Data came from subjects who underwent gynecologic surgery
at Thammasat University Hospital, Pathumthani, Thailand from January 2010 to December 2013.
Results : In the period of 4 years, there were 283 cases of elective surgery that performed via Maylard, Pfannenstiel and
midline incision by the single experience gynecologic surgeon team. One hundred and six cases were performed via Maylard
incision technique. The remaining 59 and 118 cases were performed via Pfannenstiel and midline incision technique,
respectively. Two-thirds and one-thirds of cases underwent hysterectomy and conservative surgery, respectively. Benign
conditions were the major indication for surgery at the percentage of 83.4. Operative results were not significantly different
from well-known midline and Pfannenstiel incision in terms of blood loss, time to first meal and postoperative pain. Operative
time in Maylard incision was longer than in Pfannenstiel incision. Length of stay in Maylard incision was longer than
Pfannenstiel but shorter than midline incision. Overall complications (reoperation, bowel injuries, urinary bladder injuries
and blood transfusion rate) were not significantly different.
Conclusion : Maylard incision provides similar operative results with midline and Pfannenstiel technique. Even though it
takes more time for abdominal entry but it gives more operative exposure than Pfannenstiel incision. In the woman with
previous low transverse scar and gynaecologic surgery is needed, Maylard incision could be an optional technique that
provides cosmetic and successful results. Hand on training for Maylard incision from their mentors should be encouraged to
more practice.
Keywords : Maylard, Midline, Pfannenstiel, Incision
