Kocher Subcostal Incision (Theodore Kocher), Chevron (Roof Top), and The Mercedes Benz Modification

In this article, we will discuss the Kocher Subcostal Incision (Theodore Kocher), Chevron (Roof Top), and The Mercedes Benz Modification. So, let’s get started.

Kocher Subcostal Incision (Theodore Kocher)

It gives good exposure to the gall bladder and biliary tract and can be made on the left side to access the spleen. The subcostal incision is started at the midline, 2-5 cm below the xiphoid process and extends downwards, outwards, and parallel to and about 2.5 cm below the costal margin.

Chevron (Roof Top) Modification

The incision is continued across the midline as a double Kocher incision or roof top approach (Chevron Incision), which provides excellent access to the upper abdomen. This is useful in total gastrectomy, operations for renovascular hypertension, total esophagectomy, liver transplantation, extensive hepatic resections, and bilateral adrenalectomy.

The Mercedes Benz Modification

This incision consists of bilateral low Kocher’s incision with an upper midline limb up to and through the xiphisternum. This gives excellent access to the upper abdominal viscera and, in particular to all the diaphragmatic hiatuses.

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