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   Surgical Procedure - Open appendicectomy Hide   

    Short notes on an open appendicectomy:

    Step 1 - Supine position.

    Step 2 - Mc burney’s incision or bikini line incision.
    Step 3 - Dissect through skin, sub cutaneous tissue with diathermy. Use self retaining retractor.

    Step 4 - Divide ext oblique aponeurosis in the direction of fibers. Split internal oblique fibers in their direction.

    Step 5 - Clips to peritoneum, lift it up and open with scissors. Make sure underlying structures not attached to peritoneum before opening.

    Step 6 - Feel for appendix with index finger and deliver through the wound. Babcock to tip of appendix

    Step 7 - Divide mesoappendix, ligate appendicular artery which runs along the border of mesoappendix.

    Step 8 - Divide base of appendix between artery clips. Transfixation stictch (2-0 vicryl) and ligate the base

    Step 9 - Bury with purse-string suture (3-0 prolene).

    Step 10 - Wash out with water or saline and suction

    Step 11 - Layer closure - close peritoneum with 2-0 or 3-0 vicryl

    Step 12 - Layer closure - Interrupted stitches to internal oblique 2-0 vicryl

    Step 13 - Layer closure - Close eternal oblique from lateral to medial with 2-0 vicryl

    Step 14 - Layer closure - Close Scarpas with 2-0 vicryl

    Step 15 - Layer closure - Close skin with 3-0 monocryl

    Disclaimer: These notes are to act as an aide memoire. Different methods exist. Ensure you have the proper supervision before attempting an operation that you are not competent in.

Author: Mr. Dev Mittapalli MBBS, MRCS (Eng)  | Speciality: Surgical Procedures  | Date Added: 30/03/2013


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