Appendectomy, open

  1. Skin incision

    Skin incision

    3–4cm long muscle splitting incision in right lower quadrant (at the lateral third of a virtual line from the anterior superior spine of the ilium to the umbilicus)
    Follow this by transecting the subcutis and Scarpa fascia with electrocautery.

    Note: Routine approach should be the muscle splitting incision, and not the pararectal incision, since the stacked muscles of the lateral abdominal wall virtually prevent incisional hernia. The often cited criticism that a muscle splitting incision cannot be extended if the surgical approach requires this is not correct: The muscle splitting incision may easily be extended superiad as “hockey-stick” incision and medially as modified Pfannenstiel incision.

  2. Splitting the external aponeurosis

    Splitting the external aponeurosis

    Split the external aponeurosis from laterocephalad to mediocaudad with scissors.

  3. Splitting the abominal muscles

    Splitting the abominal muscles

    Bluntly split the internal oblique and transversalis abdominis with scissors and retract with Roux retractors.

  4. Peritoneal incision

    Peritoneal incision

    Expose the peritoneum and open it with scissors.

  5. Swabbing


    Take a swab of the intraperitoneal cavity.

Coaxing out the cecum

Grasp the cecum and the appendix with a wet pad and with gentle traction coax it out through the wo

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