To the Editor.—Early surgical intervention is mandatory when appendicitis is suspected during pregnancy. That is never debated. The frequently debated topic is the choice of surgical incision.
I surveyed 170 approved training programs in surgery and obstetrics-gynecology by questionnaire. There were 111 replies. The following question was asked: For suspected appendicitis during pregnancy, which incision do you prefer? (1) Midtransverse over point of maximum tenderness; (2) Right paramedian; (3) Low midline; or (4) Other—please specify.
Fifty-five responders (49%) selected the midtransverse over point of maximum tenderness; 31 chose the right paramedian, and seven chose a low midline. There were 18 "other" choices; the majority of these were a variant of the transverse incision, such as Rocky-Davis and McBurney. Eight respondents remarked that their incision depended on the duration of gestation, but they did not specify further. However, one text recommends the "usual gridiron" incision if the pregnancy is of