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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

 

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