10 demographic trends that are shaping the U.S. and the world. By DâVera Cohn and Andrea Caumont25 comments. At its core, demography is the act of counting people. But itâs also important to study the forces that are driving population change, and measure how these changes have an impact on peopleâs lives. For example, how does immigration affect U.S. population growth?
Type of Incisions. TYPE OF INCISIONS Upper Midline The upper midline incision provides access to the esophagus, hiatus, stomach and. duodenum, pancreas, and hepatobiliary system. If extended, it allows major hepatic resection, adrenalectomy, and splenectomy.
The subcostal incision is also used for access to the liver for wedge resections; for the adrenal gland on either side; and the spleen if on the left side. When extended laterally on the right with the patient in a rotated position, the incision is used for portacaval shunts. The incision may be extended medially as an alternative to the upper midline incision. Bilateral subcostal incisions are used to access to liver for transplant and liver resections. The exposure is often helped with a vertical extension to the xyphoid. Specialized retractors such as the Olivier and some blades for the upper hand have been developed for this incision.