Introduction: The incidence of postoperative ventral hernia (PVH) after midline laparotomy range from 3 % to 20 %. It is one of the most common conditions requiring major surgery and it is a source of morbidity and requires high healthcare costs. In order to avoid this type of hernia, in 1900 a German gynecologist Hermann Johannes Pfannenstiel described the suprasymphyseal fascia crosscut laparotomy technique. The promising career of this remarkable man was tragically cut short in age of 47 years. He pricked his finger during the operation on a patient suffering from a tubo-ovarian abscess and some days later died of sepsis, repeating the fate of the Hungarian gynecologist Ignaz Zemmelweiss. Now the incision that bears his name is the incision of choice for a variety of gynecological and surgical operations. An aesthetically more pleasing «bikini-line» and less postoperative complications are mentionaed as additional advantages of this technique. 

Aim: To determine the prevalence of incisional hernia in patients with a low transverse Pfannenstiel incision compared to traditional lower midline laparotomy.

Materials and methods: 186 adult women, operated between January 2015 to December 2019, were studied for development of PVH. The kinds of the operations were different (caesarean section, abdominal hysterectomy, ovarian cystectomy, ectopic pregnancy, myomectomy). Their ages ranged from 18–58 years with mean age 34 ± 2,8 year. All patients were randomized into 2 groups. In 90 (48,4 %) patients of the first group, the lower median laparotomy was used, and in 96 (51,6 %) of the second group – the Pfanenstiel incision. PVH developed in 12(13,3 %) of patients of the first group and significantly less – in 1(1,04 %) of the second group (p <0.05).

Conclusions: The Pfannenstiel incision is characterized by a significantly lower incidence of postoperative ventral hernia, besides it’s cosmetically more acceptable than the lower midline incision and should be more widely introduced into gynecological and surgical practice.