TY - JOUR T1 - SUrgical innovators past and present AU - O’Connor DB, Winter DC Y1 - 2010/10/01 N1 - 10.1001/archsurg.2010.196 JO - Archives of Surgery SP - 1023 EP - 1024 VL - 145 IS - 10 N2 - We read with interest the article by Chang et al1 in the March 2010 issue of the Archives on the “modified Makuuchi” or “reverse L” incision. We congratulate Chang et al on their detailed and well-illustrated description of this approach, which provides excellent exposure for hepatobiliary and foregut operations. In Ireland and many parts of Europe, the reverse L incision has replaced the Mercedes incision for both liver resection and orthotopic liver transplant. Chang et al also describe an excellent technique for closure. We note their not insignificant hernia rate of 10.9%. However, hernia after liver transplant using a Mercedes incision has been reported as high as 24%2 and it will be interesting to observe if this reduces as more North American surgeons use the reverse L incision. SN - 0004-0010 M3 - doi: 10.1001/archsurg.2010.196 UR - http://dx.doi.org/10.1001/archsurg.2010.196 ER -