Pfannenstiel incision

(A) "Low" Pfannenstiel: the skin incision is placed lower for cosmetic reasons. The subcutaneous tissues are dissected to allow standard placement of rectus sheath incision. (B) Fascia is separated from rectus muscle superiorly and inferiorly. (C) The rectus muscle is separated in the midline, and the peritoneum is incised longitudinally. (D) Sutures may be placed in the rectus muscle to close a rectus diastasis. (E) Sheath is closed with continuous suture. Skin is approximated with a subcuticular suture.