Laparoscopic Appendectomy

Laparoscopic Appendectomy

The incidence of appendicitis in India is the highest in the age group of 11- 20 years which constitutes around 44.6%. The occurrence of this condition decreases as the age progresses. The occurrence of appendicitis estimates around 36.1% in the age group of 21 to 30 years and 11% in the age group of 31-40 years.

Appendicitis is a common intra-abdominal pathology that requires operative management. Acute appendicitis is a progressive blockage of the appendix, which causes tissue inflammation. Appendicitis is a medical emergency and appendectomy is the only treatment.

How is it performed?

  • The patient is administered general anaesthesia before the start of the surgery.
  • Three cannulae are used during the procedure – two are fixed in the umbilical and suprapubic position while one is placed in the right periumbilical region.
  • A small and short umbilical incision is made and one cannula is placed.
  • A laparoscope is inserted through the access and the entire abdominal cavity is viewed.
  • Instruments such as incisors, forceps and staplers are inserted after the placement of a 12-mm trocar
  • An atraumatic grasper is inserted, which exposes the appendix.
  • The appendix is retracted upward; this allows exposure of the mesoappendix.
  • The mesoappendix is divided and ligated with the help of a linear endostapler or suture ligature that is passed through the suprapubic cannula.
  • Scissors or electrocautery is used to transect the mesoappendix.
  • A linear endostapler is then used to transect the appendix.
  • The freed appendix is removed through the cannula.
  • The cannulae are extracted and sites closed with sutures.

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