PROCEDURE: APPENDECTOMY

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  1. With the patient in the supine position and after general anesthesia had been achieved, a Rockey-Davis incision was made at the McBurney point and deepened through subcutaneous tissue.
  2. Using electrocautery, the bleeders were cauterized.
  3. The external oblique aponeurosis was incised along the length of its fibers using the Metzenbaum scissors.
  4. The internal oblique and transverse abdominal muscles were split bluntly using Kelly clamps.
  5. The peritoneum was grasped with two Kelly clamps, raised and nicked with a scalpel.
  6. Immediately after which pus came through the incision in the peritoneum. The pus was cultured.
  7. The incision of the peritoneum was completed with Metzenbaum scissors.
  8. After that had been achieved, the appendix was identified, which was grasped with two Babcock clamps and raised into wound.
  9. Also, another Babcock grasped the cecum and was mobilized toward the wound.
  10. The mesoappendix was serially clamped, divided and ligated with 2-0 chromic.
  11. The appendiceal base was clamped with straight hemostats and was ligated twice with 0 chromic.
  12. The appendix was amputated, and the appendiceal stump was cauterized with electrocautery.
  13. The abdominal cavity was copiously irrigated with kanamycin solution.
  14. The wound was closed in layers.
    1. The peritoneum was closed in a continuous fashion using 2-0 Maxon.
    2. The transverse abdominal muscles and internal oblique were closed in an interrupted fashion using 2-0 Maxon.
    3. The external oblique aponeurosis was closed in a continuous fashion using 2-0 Maxon and the skin was closed with staples.

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