Evaluation of Modified Makuuchi Incision in Terms of Postoperative Pain, Incisional Hernia, and Cosmetics: Observational Study

Abstract

The modified Makuuchi incision (MMI) consists of a midline incision from the xiphoid to just above the umbilicus, and a transverse incision to the 12th rib. It is J-shaped on the right and L-shaped on the left side. We aimed to evaluate the postoperative pain, incisional hernia, and cosmetic satisfaction of patients who underwent renal surgery with this technique. Material and Methods: Between January 1, 2015 and March 31, 2021, patients who performed simple, partial, and radical nephrectomy with MMI in our clinic were determined, and whose surgery was performed at least 3 months ago and had contact information in hospital records were called by phone. They were questioned in terms of incisional pain, incisional bulging or hernia, and cosmetic appearance. Results: A total of 152 patients with kidney surgery were identified. Ninety-seven were operated via MMI, and 57 of them were interviewed. Thirty-seven were male and 20 were female. The mean age was 55.3 years (21-86 years) and the mean postoperative follow-up period was 28 months (3-75 months). There was no patient with ongoing pain and was still in need of analgesics. Fortyfive patients (78.9%) stated that they were satisfied with the cosmetic appearance. One patient (1.7%) reported incisional bulging and 1 (1.7%) reported a hernia. Conclusion: In cases with large renal tumors or a history of previous abdominal surgery, MMI did not cause permanent and serious problems in terms of pain, cosmetic, and herniation. We think that it is useful to know this incision for urologists who are interted in complicated renal surgeries.