An incision lengthed about 5-8 cm was made two fingerbreadths
from the suprasternal notch to cut open the skin and subcutaneous tissues, and to separate loose connective tissues of bilateral sternocleidomastoid muscles and infrahyoid muscles until the upper and lower planes of side thyroid lobes.
During the procedure, a Kocher incision placed about 2 fingerbreadths
above the clavicle in the midline of the neck was used to gain access.
With respect to our surgical method for CS, vertical midline incision or Pfannenstiel transverse incision (approximately 3 fingerbreadths
above and parallel to the symphysis pubis) was selected mainly on the basis of the patient's request in cases of a first nonurgent CS.
Also assessed were maternal height, abdominal circumference (measured once from the small of the back to include the widest part of the abdomen), and level of the fetal head above the pelvic brim in fifths (from five fifths being the highest to zero fifths being fully descended, using the fingerbreadths
method described by Notelowitz).
Two surface EMG electrodes (Shimmer; Dublin, Ireland) were attached two fingerbreadths
distal to the lateral epicondyle  to monitor ECRB and ECRL muscle activity during wrist extension.
Next, a lateralized Pfannenstiel incision 5-cm in length was made 2 fingerbreadths
above the symphysis pubis, and this incision was then deepened through the subcutaneous tissues.
The suture is placed around the sacrospinous ligament approximately two fingerbreadths
medial to the ischial spine, with care given to avoid injury to the pudendal neurovascular bundle (Fig.
The entry point of the Steinmann pins is noted to be three to four fingerbreadths
anterolateral to the PSIS, along a line drawn between the ASIS and the PSIS.
From the medial border of the coracoid process measure 2 of the patient's fingerbreadths
medially and 2 inferiorly onto the upper border of the pectoralis minor muscle in the delto-pectoral groove.
His other important clinical finding was tender hepatomegaly, three fingerbreadths
below the costal margin.