QS Study

The rectus sheath is made up of two parts, known as the posterior sheath and the anterior sheath. These sheaths are made of fibers of the transversus abdominis, internal abdominal oblique (IAO), and external abdominal oblique (EAO), which are muscles of the abdomen. The anterior rectus sheath is incised along a line connecting the perforators.

Steps of dissection of rectus sheath: (Skin incision)

  1. 1st incision – A longitudinal incision in the median plane from the xiphisternal junction to the symphysis pubis making a semicircular incision at the umbilicus on the dissected side. Make a vertical midline incision through the skin from the xiphoid process to the pubic symphysis.
  2. 2nd incision – A transverse incision from the upper end of the first incision, laterally for about 7.5 cm.
  3. 3rd incision – An oblique incision from the lower end of the first incision along the inguinal ligament up to its middle.

Then the skin is reflected laterally.