Tuesday, May 30, 2017

Pediatric Surgery Appendectomy

Appendectomy
Definition
In cases of acute appendicitis or as an interval appendectomy procedure.
Objectives
   To remove the appendix to prevent complications
   Invert the appendiceal stump.
Position
Supine.
Anesthesia
General with endotracheal intubation.
Procedure
1.  A 5 cm long skin crease incision of McBurney’s point on right side.
2.  Open the peritoneal cavity by separating muscles.
3.  Identify and grasp the appendix.
4.  Identify and ligate the appendicular artery.
5.  Define the base of appendix from all sides.
6.  Crush and ligate the appendix near its base.
7.  Invaginate the stump within the purse string suture.
8.  Assess for Meckel’s diverticulum, if any.
9.  Close the wound in layers.
Instruments
   General pediatric surgical set.
Suture
   3/0 Catgut                         2
   4/0 Silk                               1

   4/0 Nylon                1.


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