THE PROBLEM of how best to approach the peritoneal cavity with a minimum of postoperative complications has challenged the attention and acumen of surgeons for many years. One may consult the references given in this paper for a review of the work of the many who have contributed to this problem of the proper abdominal incision1 and the concepts of early ambulation.2
The purpose of this paper is to review briefly the fundamental anatomic and physiologic principles and to tabulate the clinical results which have led us to use routinely the transverse abdominal incision as well as to emphasize early ambulation increasingly.
Langer's lines of skin cleavage are situated transversely; hence, an incision which parallels them will close with less tension and leave a finer scar when it heals.
The oblique muscles originate laterally and, becoming aponeurotic, pass in an essentially transverse direction to insert into the linea