May 8, 2009

Laparoscopic Appendicectomy

First laparoscopic appendicectomy was performed by Dr Kurt Semm (A German gynecologist) & Dr Philippe Mouret (A French surgeon & gynecologist) in beginnings of1980's.

Laparoscopic instruments required for appendictomy:
1. Trocar & Cannula
2. Telscope
3. Grasping forceps
4. Dissector
5. Monopolar/ Bipolar cautery/ Harmonic scalpel
6. Clip applicator with clips
7. Endoloop introducer with endoloops
8. Suction cannula

Surgical procedure:
1. Hasson's/ open technique- umbilical port for camera
2. Suprapubic & Left side of abdomen in line with umbilical port for working instruments
3. Telescope introduced through umbilical port by Hasson's technique
4. CO2 insufflation done & pressure kept at 8-10 mm Hg
5. Working ports introduced
6. Appendix visualized in RIF by moving away all the small bowel loops
7. Trendelenberg's position with left tilt given
8. Appendix tip grasped & mesoappendix either cauterized & endoclips are put
9. Endoloops introduced at the base of appendix & appendix is cut in between the loops
10. Appendix removed through the umbilical port after checking haemostasis.

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