Open Appendectomy | Live surgical video
Open Appendectomy Surgical video | How to do Open Appendectomy | Techniques of doing Open appendectomy | Appendectomy for beginners | Open Appendisectomy.
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Timescale-
0:00 An intro to open appendectomy
0:26 Lanz incision
0:36 Gridiron incision, Incision for open appendectomy
1:19 External oblique muscle
1:58 Internal oblique and transversus abdominis
2:13 Tips to open peritoneum
3:02 Tenaie coli
3:14 Tips to find appendix
3:55 Mesoappendix
4:25 Appendicular artery
5:38 Riff knot or 4 finger knot
7:32 Milking of appendix and excision of appendix
8:35 Peritoneum closer by purse string suture
10:02 Layer Wise closer to appendectomy
11:45 Sub-cuticular suture in appendectomy.
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Open Appendectomy-
A surgical Removal of Appendix
On the basis of the anatomy of the anterior abdominal wall, the following three distinct incisions can be employed in performing an open appendectomy:
McBurney-McArthur incision (Gridiron)
Lanz incision
paramedian incision
Whether any of these incisions is superior to the others has not been decided in the medical literature; the final determining factor is the individual surgeon's preference. The technique described above uses the Lanz incision.
The position of the incision is based upon the location of the McBurney point, which is a point one third of the distance from the anterior superior iliac spine (ASIS) to the umbilicus.Incision was made with a No. 15 blade; electrocautery used to incise through both the superficial (Camper/ fatty) and the deep (Scarpa/membranous) fascia. External oblique aponeurosis, incised in the direction of fibers. Rest of the muscle spreading, along with appropriate retraction allows visualization of the transversalis fascia and the peritoneum. Incision on peritoneum with Metzenbaum scissors, giving access to the peritoneal cavity.
The appendix can be removed in various ways, including simple ligation, purse-stringing, and inversion appendectomy. Once the mesoappendix is divided and the appendiceal-cecal base is clearly exposed, perform simple ligation with 2-0 plain polyglactin, tying off the base; this ligation is performed twice. Place a clamp just proximal to the distal ligature on the appendix and divide sharply. Cauterize the exposed mucosa. Finally do the layerwise closer meticulously.
In above video I have shown the Techniques of doing Open appendectomy step by step with skin to skin live video.
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Link Mentioned in videos-
Purse String Sutures- • Purse String Suture live video. Tips ...
Sub-cuticular sutures- • Subcute Sutures in surgery. The Plast...
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Credits-
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