Appendectomy – How I Do It / How I Did It?
Benjamin C. Deveza
Level I Resident
OMMC – Surgery
Appendectomy
( thru Rocky Davis Incision )
Indication
Operation done for patients diagnosed with Acute Appendicitis
Usual Operative Technique
Thru Mc Burney’s or Rocky Davis Incision
Under Subarachnoid Block or General Anesthesia
How I do it / How I did it?
Pre-operative evaluation : History taking
Physical Examination – presence of direct tenderness
over the right lower quadrant
Operative technique
Patient supine under subarachnoid block or general anesthesia
Asepsis and antisepsis technique observed
Sterile drapes placed
Rocky Davis incision done at the right lower quadrant carried down to the subcutaneous
Aponeurosis of the external oblique cut along its fibers
Muscle splitting done
Peritoneum cut and entered
Intraoperative findings noted
Appendix clamped with a bobcock and its mesentery serially clamped and ligated
Base of the appendix ligated with cotton 2-0
Hemostasis checked
Correct sponge and instrument count
Fascia closed using continuous interlocking sutures with Vicryl 0
Normal saline solution with povidone-iodine washing done
Hemostasis rechecked
Skin closed with appropriate sutures
Dry sterile dressing placed
Postoperative Care
Appropriate diet
Daily wound care
Follow-up after one week for removal of sutures