THE ABDOMINAL WALLS 



249 



circumflex iliac artery (p. 253) ; in the latter, it is continued 

 along the same horizontal line through the anterior wall of 



Transpyloric 

 plane 



Right later 

 plar 



Xiphoid process 



FIG. 76. Surface Landmarks of the Anterior Abdominal Wall, showing 

 the lines of some of the commoner incisions. 



5. Infra-umbilical median incision. 



1. Exposure of gall-bladder. 



2. Supra-umbilical median incision 



3. Gastrostomy incision. 



4. Gridiron incision. 



6. Colostomy incision (through rectus). 



7. Colostomy incision. 



8. Exposure of spleen and left colic flexure. 



the rectus sheath. The muscle is retracted medially, and the 

 posterior wall of the sheath is similarly divided, care being taken 

 to avoid or to ligate the inferior (deep) epigastric artery (p. 253). 

 The abdomen may also be opened through the rectus 

 sheath. In the upper third, this route gives access to the 



