Laparoscopic appendectomy procedure
PREOPERATIVE DIAGNOSIS
Acute appendicitis.
POSTOPERATIVE DIAGNOSIS
Acute appendicitis.
PROCEDURE
Laparoscopic appendectomy.
ANESTHESIA
General.
ESTIMATED BLOOD LOSS
Minimal.
COMPLICATIONS
None.
SPECIMEN
Appendix.
FINDINGS
Nonperforated appendicitis.
DISPOSITION
To PACU in stable condition.
DESCRIPTION OF PROCEDURE
The patient was brought to the operative suite, placed supine on the operating room table. After adequate general anesthesia had been achieved, the abdomen was prepped and draped in the usual sterile fashion. Then, using a #15 blade, an infraumbilical curvilinear incision was made. The incision was extended down to underlying subcutaneous tissue and cautery was used for hemostasis. Then, the fascia was incised. The Hasson trocar was inserted to the abdomen. The abdomen was then insufflated with CO2 to create a pneumoperitoneum, and two additional 5 mm trocars were inserted to the abdomen under direct visualization, one in suprapubic region, one in left lower quadrant. As this was completed, the appendix was visualized in the right lower quadrant and noted to be acutely inflamed. However, there was no evidence of perforation. The mesoappendix was identified and then ligated with the Sonicision. Then, the base of the appendix was divided at the level of the cecum using Endo GIA stapler. The appendix was placed in an Endopouch and removed through umbilical port. The pneumoperitoneum was released and the fascia at the umbilicus was closed with 0 Vicryl suture in an interrupted figure-of-eight fashion. The skin incisions were then closed with 4-0 Vicryl in subcuticular fashion and Dermabond dressings were applied. The needle, sponge, and instrument counts were correct at the end of the case. The patient tolerated the procedure well and was then transferred to the PACU in stable condition.
Acute appendicitis.
POSTOPERATIVE DIAGNOSIS
Acute appendicitis.
PROCEDURE
Laparoscopic appendectomy.
ANESTHESIA
General.
ESTIMATED BLOOD LOSS
Minimal.
COMPLICATIONS
None.
SPECIMEN
Appendix.
FINDINGS
Nonperforated appendicitis.
DISPOSITION
To PACU in stable condition.
DESCRIPTION OF PROCEDURE
The patient was brought to the operative suite, placed supine on the operating room table. After adequate general anesthesia had been achieved, the abdomen was prepped and draped in the usual sterile fashion. Then, using a #15 blade, an infraumbilical curvilinear incision was made. The incision was extended down to underlying subcutaneous tissue and cautery was used for hemostasis. Then, the fascia was incised. The Hasson trocar was inserted to the abdomen. The abdomen was then insufflated with CO2 to create a pneumoperitoneum, and two additional 5 mm trocars were inserted to the abdomen under direct visualization, one in suprapubic region, one in left lower quadrant. As this was completed, the appendix was visualized in the right lower quadrant and noted to be acutely inflamed. However, there was no evidence of perforation. The mesoappendix was identified and then ligated with the Sonicision. Then, the base of the appendix was divided at the level of the cecum using Endo GIA stapler. The appendix was placed in an Endopouch and removed through umbilical port. The pneumoperitoneum was released and the fascia at the umbilicus was closed with 0 Vicryl suture in an interrupted figure-of-eight fashion. The skin incisions were then closed with 4-0 Vicryl in subcuticular fashion and Dermabond dressings were applied. The needle, sponge, and instrument counts were correct at the end of the case. The patient tolerated the procedure well and was then transferred to the PACU in stable condition.
Comments
Post a Comment