APPENDECTOMY

 APPENDECTOMY

The  patient  is  prepared (skin) lower abdomen  and  draped  end

aenesthelised.    A   skin  incision   transverse(Fig.20.3a)   is

preferred.   The ceacum is identified and the  appendix  isolated

and brought out of the wound.  The base clamped, ligated and  cut

(Fig.20.3b).  The stump is inverted and the wound closed.

Using a McBurny’s incision passing through MeBurry’s point

The incision cuts skin and subcutaneous tissues

External oblique aponeurosis cut in the same direction

The internal oblique fibers separated blunt in the natural direction of fibers

Peritonenium is now exposed and is opened

The underlying ceacum is delivered by rotating up and out

Appendix identified (follow the tenia)

Vessels in the mono appendix double ligated

Base of appendix crushed and clamped

Crushed base lighted end cut beyond ligature

Stump inverted by purse string suture

The wound is closed in layers.

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