In no surgical procedure has the practice of standardizing the incision proved more harmful. There can be no incision that should always be utilized, since the appendix is a mobile part of the body and may be found anyplace in the right lower quadrant, in the pelvis, up under the ascending colon, and even, rarely, on the left side of the peritoneal cavity (Figures 2 and 3). The surgeon determines the location of the appendix, chiefly from the point of maximum tenderness by physical examination, and makes the incision best adapted for exposing this particular area. The great majority of appendices are reached satisfactorily through the right lower muscle-splitting incision, which is a variation of the original McBurney procedure (Figure 1, incision A). If the patient is a woman and laparoscopic evaluation is not available, many surgeons prefer a midline incision to permit exposure of the pelvis. If there is evidence of abscess formation, the incision should be made directly over the site of the abscess.